Vincristine-Induced Bilateral Vocal Cord Palsy in an Adult Male With Diffuse Large B-Cell Lymphoma

Acute bilateral vocal cord palsy (BLVCP) is an airway emergency. Elucidating the underlying cause is imperative to enable appropriate management. Vincristine-related neurotoxicity is a potentially reversible cause of BLVCP and is rarely described in the literature. We report a case of a 65-year-old man who presented with acutely worsening dyspnoea and stridor following his fifth cycle of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy for hematological malignancy. His airway limitation was managed with supportive measures until he was able to compensate, at which point he was discharged home. His chemotherapy regimen was altered and he underwent serial examinations until he regained full vocal cord mobility at three months following his initial presentation. Through reporting this case, we hope to raise awareness of the potential for vincristine to cause sudden BLVCP and resultant airway deterioration, as well as emphasize the reversible nature of the condition with prompt cessation of therapy.