PMC9399512_01
Initial PET-CT-Scan: Marked FDG-uptake of the primary lesion and mediastinal and hilar lymph nodes (N2, Robinson 3).
gr1.jpg
PMC9399512_01_gr1.jpg
fig1
However, the PET-CT performed before transbronchial biopsy and EBUS presented the diagnosed pN2 multilevel disease (Fig. 1).
PET-CT-Scan after first two cycles of neoadjuvant chemoimmunotherapy: good response with reduced FDG-uptake.
gr2.jpg
PMC9399512_01_gr2.jpg
fig2
After two cycles a re-staging was conducted using PET-CT-Scan, which presented a good response to the established therapy with decreasing glucose metabolism in mediastinal and hilar lymph nodes and size reduction of the primary lesion (Fig. 2).
PET-CT-Scan after cycles 3 and 4 of neoadjuvant chemoimmunotherapy: No detectable FDG-uptake in lymph-nodes. Borderline elevated FDG-uptake in the primary lesion.
gr3.jpg
PMC9399512_01_gr3.jpg
fig3
Based on this, we performed restaging again, which showed a continued good response to the applied therapy and no distant metastasis (Fig. 3).
PET-CT-Scan with 1-year-follow up after resection of the right upper lobe: No detectable FDG avidity.
gr4.jpg
PMC9399512_01_gr4.jpg
fig4
Finally, the patient could be included in the regular tumor follow-up, which still showed an inconspicuous 1-year follow-up (Fig. 4) to the last, which was confirmed by our last correspondence with the patient (27 months after diagnosis, 20 months after surgery).