Background: Obtaining the history of the medical disease sometimes can be difficult and confusing. Some life important issues can be hidden by the patient and may jeopardize the medical examination
and understanding of the disease.Case Report: Recently we had a case of a young patient that presented a wide clinical feature, combining entities of several pulmonary differential diagnosis. The severity of the presentation and the background information drug abuse that influenced the speed of diagnostic procedure. The final diagnosis was tracheal large cell carcinoma.Conclusions: Dealing with human nature sometimes is very difficult and it is constantly reminding us always to expect the unexpectable and be able to react accordingly.

Keywords: lung cancer pneumothorax, drug abuse