Nowadays lung cancer is regarded as the leading cause of cancer-related death, leading to a mortality number of nearly 1.8 million annually [1]. Lung adenocarcinoma, as a relatively common pathological type of lung cancer in clinical practice, shows a gradually increasing tendency and ranks top in both morbidity and mortality rate among all malignant tumors[2]. In recent years, rapid progress in tumor immunotherapy and tracheoscopy intervention technology provide more possibilities for the treatment of lung adenocarcinoma. Here we report an 83-year-old patient diagnosed with lung adenocarcinoma stage IV who achieved partial clinical remission after receiving 4 periods of systemic intravenous administration and 2 periods of intratumoral administration of tirellizumab under tracheoscopy. By follow-up on August 24, 2024, the patient’s tumor was still shrinking without any treatment-related adverse reactions. Based on this case, it is suggested that systemic intravenous tirelizumab combined with tracheoscopic intratumoral injection may provide a safe and effective strategy for patients with lung adenocarcinoma, especially for those who cannot tolerate chemotherapy or surgery. However, further prospective studies and more clinical experiments are still needed to confirm our hypothesis.

Introduction: Lung cancer is a leading cause of cancer-related deaths, with an annual mortality rate of nearly 1.8 million. Among its subtypes, lung adenocarcinoma is increasingly prevalent. Due to its often asymptomatic nature, most patients are diagnosed at advanced stages, missing the optimal window for surgery and resulting in a poor 5-year survival rate. Case presentation: We present the case of an 83-year-old patient with stage IV lung adenocarcinoma treated with four cycles of intravenous Tirelizumab and two cycles of intratumoral Tirelizumab via tracheoscopy. The patient achieved partial clinical remission, with tumor lesions continuing to shrink upon follow-up by August 24, 2024. No treatment-related adverse reactions were observed, and the patient’s immune function remained normal. Conclusions: This case suggests that systemic intravenous Tirelizumab combined with tracheoscopic intratumoral injection may offer a safe and effective treatment strategy for lung adenocarcinoma, particularly for patients unsuitable for chemotherapy or surgery. However, further prospective studies and clinical trials are needed to validate these findings.