Pulmonary artery occlusion post immunotherapy for hilar node-positive lung cancer

We present the case of a patient who developed pulmonary artery occlusion following immune-checkpoint inhibitor (ICI) therapy for non-small cell lung cancer. A 69-year-old man with squamous cell carcinoma (yc-T1cN0M0), initially diagnosed at c-stage IVA (T3N1M1b), in the upper lobe of the left lung, was scheduled to undergo salvage lung resection after ICI therapy. However, he exhibited an occlusion of the lingular pulmonary artery near the clinically metastatic hilar lymph node. To avoid severe adhesions, the patient underwent successful wedge resection without dividing pulmonary vessels and was discharged without complications. Surgeons should be prepared for pulmonary artery changes following ICI therapy.