Hydrocarbon pneumonitis mimicking lung cancer in a truck driver: A case report

Hydrocarbon pneumonitis is an uncommon condition that can radiologically mimic malignancy, particularly in patients with risk factors for lung cancer. We report the case of a 52-year-old male truck driver with a 15 pack-year smoking history who presented with persistent cough and mild weight loss. Initial imaging revealed a mass-like consolidation in the right middle lobe (RML) and multiple hepatic lesions, raising concern for metastatic lung cancer. Comprehensive history-taking eventually revealed a single episode of gasoline siphonage approximately 10 days prior to symptom onset, involving direct oral suction of fuel for several seconds, with estimated aspiration of a small volume (< 5 mL). This acute, high-intensity exposure preceded symptom onset and was pivotal in redirecting the diagnosis. Further radiological evaluation confirmed hydrocarbon pneumonitis with incidental hepatic hemangiomas, avoiding unnecessary invasive procedures. This case highlights the critical importance of thorough occupational and environmental exposure history in patients presenting with pulmonary opacities, particularly when radiological findings suggest malignancy.