What happened, in summary

A 56-year-old man with Stage III squamous cell cancer of the right lung received nab-paclitaxel, carboplatin and tislelizumab. The lung lesion shrank, allowing right middle lobectomy with mediastinal lymph-node dissection. After surgery, he received 4 additional cycles of chemotherapy with tislelizumab followed by 4 cycles of tislelizumab alone. Before another cycle, he developed fatigue, vomiting, weight loss and an itchy rash. Testing showed low morning cortisol and ACTH levels, and adrenal insufficiency was diagnosed. Hydrocortisone replacement improved his hormone levels. He later received another tislelizumab maintenance dose, but his cortisol fell again, so immunotherapy was discontinued and steroid replacement restarted. Updated follow-up found no cancer recurrence or metastasis. His journey combined systemic treatment and surgery with a significant immune-related endocrine complication that repeatedly interrupted immunotherapy. He remained without evidence of recurrent disease at the latest follow-up while the adrenal problem continued to require management.