Don't sit on chronic inflammation

White, Timothy John; Cronin, Andrew; Lo, Michael F.; Huynh, Fred; Donahoe, Simon; Lynch, A. C.; Heriot, Alexander G.

doi:10.1111/j.1445-2197.2011.05989.x

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…Malignant transformation is a rare but well-known complication of long-standing SPD, occurring in approximately 0.1% of patients with recurrent and complex SPD [2, 8, 9, 15, 16]. SCC is the most common carcinoma associated with chronic SPD, although basal cell carcinoma, sweat gland adenocarcinoma, and verrucous carcinoma have also been reported [2, 5, 17].…”

Section: Discussionmentioning

confidence: 99%

“…SCC is the most common carcinoma associated with chronic SPD, although basal cell carcinoma, sweat gland adenocarcinoma, and verrucous carcinoma have also been reported [2, 5, 17]. The pathogenesis of malignant transformation in SPD is thought to be similar to that associated with other chronic ulcerative and scarifying cutaneous disorders, such as Marjolin’s ulcer [2]. It is believed that this process, on the molecular basis, is caused by the release of free oxygen radicals by activated inflammatory cells, inducing genetic damage and neoplastic transformation [9].…”

Section: Discussionmentioning

confidence: 99%

“…Cases of necrotizing wound infections, sacral osteomyelitis, meningitis, and malignant degeneration associated with pilonodal disease have also been reported [7]. Malignant transformation occurs in about 0.1% of patients and usually involves squamous cell carcinoma (SCC) [2, 8, 9]. We report an extremely rare case of SCC developing in a 60-year-old man with chronic pilonidal disease complicated by an anal fistula.…”

Section: Introductionmentioning

confidence: 99%

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Squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease: a case report

et al. 2017

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BackgroundSacrococcygeal pilonidal disease is a chronic, well-recognized entity, characterized by the recurrent formation of an abscess or draining sinus over the sacrococcygeal area. It is one of the most common surgical problems. Rarely, chronic inflammation and recurrent disease leads to malignant transformation, most commonly to squamous cell carcinoma (SCC).Case presentationWe describe an extremely unusual case of SCC developing in a 60-year-old patient with a chronic pilonidal sinus complicated by an anal fistula. After wide surgical excision of the pilonidal sinus and fistulas and because of the poor healing process 6 months later, colonoscopy and a percutaneous fistulography were performed, revealing an anal canal-pilonidal fistula. Patient was treated with a more radical surgical resection with a prophylactic loop colostomy, but healing was not accelerated. Multiple biopsies were then taken from the surgical site at the time, which revealed the development of SCC. CT and MRI imaging techniques revealed SCC partial invasion of the coccyx and sacrum. As a result, aggressive surgical approach was decided. Histological examination revealed moderately to poorly differentiated SCC, and the patient was treated with adjuvant radiation therapy postoperatively. Nine months later, recurrence was found in the sacrum and para-aorta lymph nodes and the patient died shortly after. We discuss the clinical features, pathogenesis, treatment options, and prognosis of this rare malignant transformation.ConclusionsThe development of SCC in chronic pilonidal disease is a rare but serious complication. Symptoms are usually attributed to the sacrococcygeal pilonidal disease (SPD), and diagnosis is often made late by histological examination of biopsies. Malignant transformation should be suspected in chronic SPD with recurrent episodes of inflammation, repeated purulent discharge, poor healing, and chronic complex fistulas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease: a case report

et al. 2017

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“…We report the 128 th published case of carcinoma arising from psD which had a fast progression leading to death with pulmonary metastases. Incidence of psDCa is considered to be about 0,1% [6]. Incidence of psD is increasing over the last years [5] this might lead to rising numbers of carcinomas arising psD.…”

Section: Discussionmentioning

confidence: 99%

“…It is a common, histologically benign condition with a tendency of rising incidence [5]. Development of carcinoma on the ground of psD has only been described anecdotally with a frequency of one in a thousand patients (0,1%) [6].…”

Section: Introductionmentioning

confidence: 99%

Pilonidal Sinus Carcinoma dying from Squamous Cell Carcinoma within 14 months after Diagnosis.

Dettmer

Bonni²,

Degiannis

et al. 2022

AJTES

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Introduction: The incidence of Pilonidal Sinus Disease (PSD) is increasing worldwide, especially in the developing and developed countries. As long-standing chronic infection may trigger neoplastic transformation, more carcinoma arising from PSD are to be expected with an incidence of 0,1%. Methods: Case report describing a Squamous cell carcinoma (SCC) arising from PSD Results: A 60-year-old male presented with a 6cm x 10cm ulcerating wound in the sacrococcygeal area, which was painful for 3 months. A biopsy initially revealed a highly differentiated squamous cell carcinoma (cT3cN1acM0G1). Soft tissue MRI showed possible infiltration of the coccyx, and a staging CT showed suspicious enlarged lymph nodes within both inguinal regions. The patient underwent a full 20x1,8 Gy chemoradiation with partial response of the primary. Surgical Resection was recommended. The patient did not show up for follow-up after chemoradiation and refused further treatment. He demised after 14 months due to pulmonary metastases. Conclusion: Even a curative intended chemoradiation of this highly differentiated tumour led to a dismal outcome of disease after 14 months. Cases of PSD carcinomas often present as atypical cutaneous SCC.

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