Objective:

To report a case of an elderly patient with occult lung squamous cell carcinoma (LUSC) achieving a complete response after treatment with penpulimab and anlotinib.

Approach:

• Patient Background: An 83-year-old man with a history of hypertension and atrial fibrillation presented with hoarseness and cough. He had a 30-pack-year smoking history.
• Diagnostic Assessment: Enhanced chest CT revealed a mediastinal mass and multiple lymph node metastases. A biopsy confirmed metastatic poorly differentiated squamous cell carcinoma.
• Treatment: The patient was treated with penpulimab and anlotinib, resulting in a complete remission after ten cycles, which lasted over two years.

Key Findings:

• The patient achieved a durable complete response after treatment with penpulimab and anlotinib, lasting over two years.
• No adverse effects were observed during or after treatment.
• The therapy was continued for 26 months before being stopped at the patient's request.

Interpretation:

Limitations:

• PD-L1 expression was not assessed due to the patient's refusal, limiting conclusions about predictive factors for treatment response.
• Financial constraints led to the decline of further diagnostic interventions.

Conclusion: