What happened, in summary

A 59-year-old man was admitted on June 14, 2022, because of hemoptysis. Contrast-enhanced chest CT showed a 69 x 63 mm space-occupying lesion in the lower lobe of the right lung, with enlarged mediastinal and right hilar lymph nodes and enlarged bronchial and intercostal arteries. Pathology confirmed squamous cell carcinoma. The multidisciplinary team diagnosed right lung squamous cell carcinoma staged cT3N2M0, Stage IIIB, and recommended preoperative neoadjuvant treatment. On June 22, 2022, he underwent drug-eluting bead bronchial arterial chemoembolization, or DEB-BACE. On June 23, he received tislelizumab 200 mg intravenously. Hemoptysis decreased substantially, and he was discharged 5 days after the procedure. After discharge, he had intermittent fever and coughed up a large amount of gray-black necrotic material, but no massive hemoptysis occurred. He was readmitted on July 15, 2022. Repeat contrast-enhanced CT showed that the right lower-lobe lesion had developed a clear cavity and decreased to 63 x 56 mm, meeting partial-response criteria. After surgical evaluation, he underwent thoracoscopic right middle and lower lobectomy with lymph-node dissection. The operation was smooth, with about 50 mL of blood loss. Pathologic evaluation showed a complete response, with no viable tumor reported. He subsequently received 6 rounds of postoperative chemotherapy combined with immunotherapy. The latest CT reexamination was stable and reassuring, supporting strong disease control after neoadjuvant chemoembolization, immunotherapy, surgery, and postoperative systemic treatment. The case is clinically useful because hemoptysis made immediate local control important, while tumor necrosis and cavitation after DEB-BACE plus tislelizumab suggested substantial preoperative treatment effect before resection.