What happened, in summary

This 63-year-old man had a small mixed pulmonary nodule first found during a physical examination in June 2019. The nodule measured about 8 mm, and he was monitored with chest CT every 6 months. For 4 years, the nodule changed very little. In March 2023, it measured 8.5 × 6.1 mm, but by September 25, 2023, it had grown to 19 × 18 mm, and enhanced CT suggested peripheral lung cancer. He had smoked 20 cigarettes per day for 40 years and had mild chronic obstructive pulmonary disease, but he had no other major medical conditions or family history of cancer. After discussion of diagnostic and treatment options, he chose a minimally invasive approach using CT-guided electromagnetic navigation for both biopsy and laser ablation. On October 17, 2023, CT was used to choose the puncture point and place electromagnetic navigation locators. Under local lidocaine anesthesia, the biopsy sheath was guided to the lesion. Rapid on-site evaluation showed atypical cells suggestive of adenocarcinoma, and final pathology confirmed lung adenocarcinoma. During the same procedure, a 980-nm semiconductor laser fiber was inserted into the lesion. Ablation was performed at 7 W for 30 seconds, paused for 60 seconds, then repeated for another 30 seconds. CT after ablation showed a cavity in the lesion center and surrounding ground-glass opacity. He tolerated the procedure well and was able to perform simple activities the next day. One month later, PET-CT showed no significant metabolic increase in the treated nodule, consistent with complete tumor ablation. No procedure-related complications were reported.