Relapsing Polychondritis Associated With Thyroid Carcinoma: A First Malagasy Case

Abstract

Relapsing polychondritis (RP) is a rare disease characterized by recurrent systemic inflammation affecting cartilaginous tissues and proteoglycan-rich tissues. The disease may present in several clinical variants, which can delay diagnosis. Corticosteroids are the treatment of choice for RP. In rare cases, RP can be paraneoplastic. The association of RP with thyroid cancer is unusual. We report the first Malagasy case of a 48-year-old man with RP type one diagnosed within less than a year, presenting with recurrent chondritis of the auricular cartilage, tracheobronchial chondritis, and recurrent episcleritis. The disease was associated with papillary thyroid carcinoma.

Keywords: auricular chondritis; cancer; relapsing polychondritis; tracheobronchial chondritis.

Figure 1

(a-b) Inflammatory swelling of the right ear, sparing the noncartilaginous lobule. (c) Normal appearance of the right ear at 5 months of corticosteroid treatment.

Figure 2

Cervicothoracic CT scan with and without contrast, frontal view showing tracheobronchial wall thickening with right apical atelectasis (yellow arrow).

Figure 3

Bronchial biopsy Legends: (1) normal mucosa; (2) chronic inflammation of the stroma; and (3) cartilage Staining: Hematoxylin and eosin Magnification x100. Source: Laboratory of Anatomy and Pathological Cytology of University Hospital Center Jospeh Ravoahangy Andrianavalona in Antananarivo, Madagascar.

Figure 4

Papillary thyroid carcinoma on surgical specimen Legends: (1) papillary axes and (2) thyrocytes with a frosted glass appearance, overlapping staining: Hematoxylin and eosin Magnification x100. Source: Laboratory of Anatomy and Pathological Cytology of University Hospital Center Jospeh Ravoahangy Andrianavalona in Antananarivo, Madagascar.