64 yr old male with history of smoking

Presented with RUL mass noted on CXR

Past medical history – high blood pressure, no CAD

WHO PS1

PFT- FEV1 81% predicted; DLCO 86% predicted

CT thorax abdomen – right upper lobe tumor & enlarged station 4R (25.6 mm x 17.4 mm)

EBUS – positive 4R, 11R; negative 7, 4L, 10R

PET-CT - FDG right hilar adenopathy lymph node T2 N2 M0

MR Brain – no metastases

Treatment – IMRT 66 Gy, concurrently with paclitaxel and carboplatin

4 weeks post CRT

Decision to start with durvalumab 5 weeks after completion of CRT for a duration of 12 months

2 months post CRT (on durvalumab)

PET-CT – Decreased avidity RUL mass and R hilar adenopathy

8 months post CTRT (on durvalumab)

PET-CT- No FDG avidity in RUL mass, increased avidity R hilar adenopathy, no metastases

EBUS- positive 4R; negative 7, 4L

Referred for surgical evaluation

PFT- FEV1 71% predicted; DLCO 74% predicted MRI Brain – no metastases Treatment - Robotic resection