Cartilage calcification of the ears secondary to adrenal insufficiency

Abstract Calcification of the auricular cartilage is a rare condition, associated with either local or systemic causes. Among systemic causes, endocrine disorders, particularly adrenal insufficiency, are the most frequently reported. A 41-year-old man presented with a 1-year history of stiffness and pain in both ears. The ears became swollen and erythematous and, over time, they became painful to touch or move. Physical examination revealed rigid, immobile auricles. Biopsy, X-ray and computed tomography (CT) confirmed cartilage calcification. Laboratory tests showed markedly low cortisol and adrenocorticotropic hormone levels, leading to the diagnosis of secondary adrenal insufficiency. Auricular cartilage calcification is a rare but significant manifestation of adrenal insufficiency. Skull X-rays, noncontrast CT and laboratory tests are essential for diagnosis. No effective treatment currently exists to reverse calcification. Early recognition and hormone replacement therapy can prevent further progression.