Rapidly progressive relapsing polychondritis following surgery for lung adenocarcinoma: a case report

TL;DR

A 75-year-old man developed rapidly progressing relapsing polychondritis after lung cancer surgery, highlighting the rare but serious connection between the two conditions.

Contribution

This case report documents a rare instance of RP occurring after lung cancer surgery, expanding understanding of its potential paraneoplastic association.

Findings

RP developed within 90 days after lung adenocarcinoma surgery in a 75-year-old patient.

The patient's RP was complicated by severe infections and hemophagocytic syndrome, leading to a fatal outcome.

The case suggests RP can arise post-tumor resection, not just before or during tumor onset.

Abstract

Relapsing polychondritis (RP) is a rare autoimmune disease. This paper reports a unique case of RP with rapid progression after surgery for lung adenocarcinoma.

A 75-year-old man presented with a right upper lung mass on physical examination, which was finally diagnosed as invasive adenocarcinoma (stage IB) by pathology, and underwent thoracoscopic lobectomy without further chemotherapy or immunotherapy. Within 90 days after surgery, the patient developed shortness of breath, cough, and redness and swelling of the ear, and he was subsequently diagnosed with RP after pathological examination of the auricular cartilage. The patient experienced temporary improvement with mechanical ventilation, methylprednisolone, and intravenous immunoglobulin therapy, during which time comprehensive rehabilitation was initiated. However, he subsequently developed upper gastrointestinal bleeding, polymicrobial infections, and hemophagocytic syndrome, which proved fatal.

This case highlights the rare temporal correlation of RP as a paraneoplastic syndrome that can occur prior to or concurrently with tumor onset, but it may also arise following tumor resection. Because of the rarity and adverse consequences of RP, clinicians should improve their recognition of the disease to permit early diagnosis and treatment.

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