Vincristine-induced dysphagia suggesting esophageal motor dysfunction: A case report

Transient esophageal motor dysfunction with dysphagia was observed in a 62- year-old man receiving vincristine-containing chemotherapy for non-Hodgkin' s lymphoma. Neurological examinations, including muscle strength of extremi ties, deep tendon reflexes and cranial nerves, were normal. However, the pa tient complained of severe numbness in the fingertips and toes. The results of esophagogram and esophagoscopy were unremarkable. However, a significan tly prolonged esophageal transit time was observed. Vincristine was conside red as the causative agent. Empirical vitamin and metoclopramide were presc ribed for his neurological symptoms but there was no improvement. The sympt oms of dysphagia subsided spontaneously 2 weeks later. However, prompt recu rrence of severe dysphagia was observed again after administration of the s econd and third courses of treatment, which again disappeared upon disconti nuation of the drug. Peripheral nerves and the gastrointestinal tract are o ften affected by vincristine. Common gastrointestinal tract symptoms of vin cristine neuropathy may be colicky abdominal pain and constipation. However , vincristine-induced esophageal motor dysfunction with dysphagia is uncomm on but generally reversible. The oncologist and chemotherapist should be aw are of this complication.