Relapsing polychondritis occurring after esophageal cancer surgery: a case report with a literature review.

Mase, Junichi; Tanaka, Yoshihiro; Sato, Yuta; Imai, Takeharu; Okumura, Naoki; Matsuhashi, Nobuhisa; Takahashi, Takao; Yoshida, Kazuhiro

INTRODUCTION Relapsing polychondritis is a relatively rare chronic inflammatory disease of unknown etiology. In this case the treatment for esophageal cancer may have triggered relapsing polychondritis. CASE PRESENTATION A 70-year-old man complained of dysphagia and weight loss. An upper gastrointestinal endoscopy revealed type 2 advanced esophageal cancer. A subtotal esophagectomy and three-region lymph node dissection were performed after chemotherapy. One month later, the patient developed respiratory distress accompanied by wheezing, dizziness, and hearing loss. The symptoms improved within a few days. The frequency of respiratory distress increased and the patient visited our department. Pharyngeal endoscopy revealed narrowing of the glottic space and a subglottic tumor. No malignant findings were found histopathologically on the biopsy specimens, but infiltration of inflammatory cells was observed. We diagnosed relapsing polychondritis based on the histopathological findings of the pharyngeal cartilage, in addition to the osteolytic changes of the cricoid cartilage on CT. The symptoms were relieved after the administration of oral steroids. Despite tapering of the steroids, no recurrence of relapsing polychondritis occurred. There was no evidence of esophageal cancer recurrence. CONCLUSION Early diagnosis and treatment for relapsing polychondritis are necessary because this condition is often associated with airway lesions. Esophageal cancer treatment may trigger relapsing polychondritis.