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2011, Number 4

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Cir Cir 2011; 79 (4)

Malignant degeneration of pilonidal disease

Alarcón-del Agua I, Bernardos-García C, Bustos-Jiménez M, Serrano-Borrero I, Casado-Maestre MD, Docobo-Durantez F

Language: Spanish
References: 11
Page: 374-378
PDF size: 301.85 Kb.


ABSTRACT

Background: Pilonidal disease is one of the most frequent entities in our daily surgical activity. Although it is a benign disease, malignant degeneration is likely to occur in pilonidal disease. We reviewed surgical interventions for pilonidal diseases performed from January 1, 1995 to December 31, 2008.
Clinical case: We reviewed all 3729 histology reports obtained after surgical removal of pilonidal disease. There were three cases of squamous cell carcinoma and one case of basal cell carcinoma. Patients affected by squamous cell carcinoma had a mean age of 54.2 years and a mean time of evolution of the lesions of 20.6 years. We found local recurrence and lymph node recurrence. Mean follow-up period was 5 years and there was no mortality. The patient with basal cell carcinoma had 1 year of pilonidal disease evolution. There were no recurrences.
Conclusions: Malignancy can arise in pilonidal diseases with a long evolution time. There is a high rate of recurrence and morbimortality in cases of squamous cell carcinomas. Adjuvant radiotherapy in addition to complete local excision has demonstrated a decrease in the rate of local recurrence.


REFERENCES

  1. Townsend CM. Pilonidal disease. En: Townsend CM, Beauchamp RD, Evers BM, Mattox K, et al., eds. Sabiston Textbook of Surgery. 17th ed. Philadelphia: Saunders; 2004. p. 1500.

  2. Chintapatla S, Safarani N, Kumar S. Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol 2003;7:3-8.

  3. Buie L. Jeep disease. South Med J 1944;37:103-109.

  4. Davis KA, Mock CN, Versaci A, Lentrichia P. Malignant degeneration of pilonidal cysts. Am Surg 1994;60:200-204.

  5. Kulaylat MN, Gong M, Doerr RJ. Multimodality treatment of squamous cell carcinoma complicating pilonidal disease. Am Surg 1996;6:922-929.

  6. Malek MM, Emanuel PO, Divino CM. Malignant degeneration of pilonidal disease in an immunosuppressed patient: report of a case and review of the literature. Dis Colon Rectum 2007;50:1475-1477.

  7. Williamson JD, Silverman JF, Tafra L. Fine-needle aspiration cytology of metastatic squamous-cell carcinoma arising in a pilonidal sinus, with literature review. Diagn Cytopathol 1999;20:367-370.

  8. Abboud B, Ingea H. Recurrent squamous-cell carcinoma arising in sacrococcygeal pilonidal sinus tract: report of a case and review of the literature. Dis Colon Rectum 1999;42:525-528.

  9. Cohen AM, Wong WD. Anal squamous cell cancer nodal metastases: prognostic significance and therapeutic considerations 1996;62:922–929.

  10. de Bree E, Zoetmulder FA, Christodoulakis M, Aleman BM, Tsiftsis DD. Treatment of malignancy arising in pilonidal disease. Ann Surg Oncol 2001;8:60–64.

  11. Alecha Gil J, Echenique-Elizondo M, Amondarain MA, Górriz Arias G. Carcinoma epidermoide sobre sinus pilonidal. Oncología 2006;29:227-230.




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