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Photodynam ic therapy (PDT) can be used as palliative therapy to reduce obstructive symptoms in patients with advanced lung cancer. Herein, we report on the case of a patient w ith fatal broncho-m ediastinal fistula after PDT. A 57-year-old woman was diagnosed as non-small cell lung cancer (squamous cell carcinom a, cT4N3). She received PDT on the endobronchial m ass ob-structing her right main bronchus twice in 48 hours interval. Two weeks later, concurrent chemoradiation therapy (CCRT) with weekly Paclitaxel/Carboplatin was started. During m aintenance chem otherapy, a new nodule in her scalp developed and turned out to be a m etastatic nodule. A broncho-m ediastinal fistula was suspicious on follow-up chest com puted tom ography and a broncoscopy revealed an extensively damaged medial right main bronchial wall. On the day following bronchoscopy, the patient died of sudden m assive hem optysis. (J Lung Cancer 2011;10(2):102 104) Key Words: Lung cancer, Photodynamic therap