Delayed genital necrosis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with Mitomycin-C

Scrotal Necrosis Following Heated Intra-peritoneal Chemotherapy: Case Report and Review of the Literature

“…The anti-inflammatory effects of the aforementioned agents may mitigate the response elicited by MMC and allow the lesions to demarcate prior to surgical excision. This is supported by two cases that were prematurely excised and complicated by impaired wound healing and secondary necrotic lesions [ 13 ].…”

“…The literature documenting this complication is limited. Table 1 summarizes the clinical data from five case reports [ 9 - 12 ], and one case series published by Baron et al based on a total of 13 cases retrospectively identified from two specialized centers [ 13 ]. MMC was used as the intra-peritoneal chemotherapy agent of choice for all 18 cases.…”

“…Moreover, the rate of progression of the lesion and its positive response to steroids have not been described elsewhere. Other authors have documented minimal to partial improvement of symptoms with systemic antibiotics [ 9 , 13 ]. Fabiana et al also reported partial improvement with topical scavenger agent dimethyl sulfoxide [ 10 ].…”

“…Fabiana et al also reported partial improvement with topical scavenger agent dimethyl sulfoxide [ 10 ]. While this approach was deemed inadequate, Baron et al highlighted the significance of early conservative measures to prevent premature operative management [ 13 ]. The anti-inflammatory effects of the aforementioned agents may mitigate the response elicited by MMC and allow the lesions to demarcate prior to surgical excision.…”

“…A rare yet important complication is scrotal pain and ulceration after MMC administration in HIPEC. Only a few recorded cases have been described in the literature [ 9 - 13 ]. This is a case report of scrotal necrosis after HIPEC for adenocarcinoma of the colon with peritoneal metastasis (PM).…”