Vanishing lung syndrome masquerading as pneumothorax in a smoker: Now you see me, now you do not

A rare clinical syndrome, giant bullous emphysema, also known by the name of vanishing lung syndrome (VLS), is characterized by an X-ray of the chest showing disappearance of the lung. VLS is a chronic disease that progresses gradually and is usually seen in young male smokers, with other risk factors being alpha-1 antitrypsin deficiency and marijuana abuse. Giant emphysematous bullae are a pathognomonic presentation with a preference towards the upper lobe of the lungs. These emphysematous bullae may remain dormant for a long duration before presenting as worsening dyspnoea. Computed tomography is an essential tool to diagnose VLS. The treatment modalities include surgical and thoracoscopic resection of the bullae. We have reported a rare case of VLS in a 58-year-old chronic smoker managed conservatively.