Multimodal approach for the comprehensive management of non-small cell lung cancer: a case report

Lung squamous cell carcinoma (LSCC) is a common malignant tumor with a high incidence rate and poses a serious threat to patients' health and quality of life. This case reports the complex diagnosis and treatment process of a patient with LSCC of the right upper lobe, which has important clinical research value.

The patient was diagnosed with LSCC of the right upper lobe in January 2024, and attended the hospital 4 months after stent implantation in the right main bronchus. In 2024, the patient was diagnosed with moderately differentiated LSCC of the right upper lobe (T2N3M0, stage IIIB). After three cycles of chemotherapy combined with immunotherapy, the patient underwent sleeve resection of the upper lobe of the right lung when tumor was downgraded. Following the operation, the patient developed pulmonary infection and immune-related pneumonitis. His condition was relieved after various anti-infection treatments and hormone intervention. Postoperatively, the patient developed anastomotic stenosis, which was initially managed with the implantation of a silicone stent. The subsequent course was complicated by a pan-drug-resistant Acinetobacter baumannii infection, contributing to restenosis and necessitating stent exchange to a covered metal stent. The etiological examination revealed pan-drug-resistant Acinetobacter baumannii infection. After adjusting the treatment plan based on the drug sensitivity results, the infection was effectively controlled. Following confirmation of airway healing, the stent was successfully removed. At present, the patient's respiratory symptoms have improved, and his activity endurance has increased.

This case demonstrates the complexity of multi-stage treatment, including chemotherapy, surgery, anti-infection and immunotherapy, for a patient with LSCC of the right lobe, accompanied by multiple complications. Bronchial stent implantation and adjustment significantly improved the airway obstruction, while the precise anti-infection strategy based on etiology effectively controlled the infection. Consideration of factors such as the patient's smoking history had an important impact on the development of the disease and the therapeutic effect.