Background: Many cytotoxic drugs can cause pulmonary injury in different degrees. Fatal pulmonary injury due to gemcitabine therapy was reported in literature only in three cases.Case Report: Massive pulmonary hemorrhage in patient with pancreas cancer after first use of gemcitabine is presented. The patients died of pulmonary insufficiency 6 days after the first gemcitabine dministrationConclusions: Patients receiving gemcitabine treatment should be followed-up carefully for this fatal pulmonary toxicity.

Keywords: Gemcitabine, pulmonary injury, pancreas carcinoma