Nivolumab-related tracheobronchial chondritis: Extremely rare manifestation of an immune-related adverse effect

Head Neck. 2020 Nov;42(11):E43-E48. doi: 10.1002/hed.26456. Epub 2020 Sep 5.


Background: Programmed death-1 checkpoint inhibitors, such as nivolumab, have successfully been utilized for recurrent or metastatic squamous cell carcinoma of the head and neck; however, their use may be associated with immune-related adverse effects (irAEs).

Methods: We describe a case of tracheobronchial chondritis as a rare irAE in a 72-year-old man with multiple pulmonary metastases of hypopharyngeal squamous cell carcinoma treated with nivolumab, who was seen with a 2-week history of fever, nonproductive cough, and dyspnea.

Results: CT revealed a thickened tracheobronchial wall and narrowed intraluminal space resulting in respiratory symptoms, despite significant clinical response of the metastases. He was clinically diagnosed with tracheobronchial chondritis and treated successfully by steroid therapy. His diagnosis was confirmed by a positive serum anti-collagen type 2 antibody test.

Conclusions: In addition to interstitial lung disease, tracheobronchial chondritis should be considered as a possible irAE in patients with acute respiratory symptoms after nivolumab administration.

Keywords: head and neck cancer; immune-related adverse event; nivolumab; relapsing polychondritis; tracheobronchial chondritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Drug-Related Side Effects and Adverse Reactions*
  • Head and Neck Neoplasms*
  • Humans
  • Lung Neoplasms* / drug therapy
  • Male
  • Nivolumab / adverse effects
  • Squamous Cell Carcinoma of Head and Neck


  • Nivolumab