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.
Luedi, M.M., et al., Global Gender Differences in Pilonidal Sinus Disease: A Random-Effects Meta-Analysis. World J Surg, 2020. 44(11): p. 3702–3709.
Bosche, F., et al., The Hair in the Sinus: Sharp-Ended Rootless Head Hair Fragments can be Found in Large Amounts in Pilonidal Sinus Nests. World J Surg, 2018. 42(2): p. 567-573.
Doll, D., et al., The presence of occipital hair in the pilonidal sinus cavity-a triple approach to proof. Int J Colorectal Dis, 2018. 33(5): p. 567-576.
Downing, J.G., Barbers' pilonidal sinus. J Am Med Assoc, 1952. 148(17): p. 1501.
Dettmer, M., et al., Gender differences in axial hair strength may explain gender related incidence variation in Pilonidal Sinus patients. PSJ, 2021. 7(1): p. 11-20.
White, T.J., et al., Don't sit on chronic inflammation. ANZ J Surg, 2012. 82(3): p. 181-182.
Yuksel, M.E. and F. Tamer, All pilonidal sinus surgery specimens should be histopathologically evaluated in order to rule out malignancy. J Visc Surg, 2019. 156(5): p. 469-470.
Abboud, B. and H. Ingea, Recurrent squamous-cell carcinoma arising in sacrococcygeal pilonidal sinus tract: report of a case and review of the literature. DCR, 1999. 42(4): p. 525-528.
Kulaylat, M.N., M. Gong, and R.J. Doerr, Multimodality treatment of squamous cell carcinoma complicating pilonidal disease. Am Surg, 1996. 62(11): p. 922-929.
Mentes, O., M. Akbulut, and M. Bagci, Verrucous carcinoma (Buschke-Lowenstein) arising in a sacrococcygeal pilonidal sinus tract: report of a case. Langenbecks Arch Surg, 2008. 393(1): p. 111-114.
Al-Zacko, S.M., Malignancy in chronic burn scar: a 20 year experience in Mosul-Iraq. Burns, 2013. 39(7): p. 1488-91.
Silberstein, E., et al., Lymph Node Metastasis in Cutaneous Head and Neck Squamous Cell Carcinoma. Dermatol Surg, 2015. 41(10): p. 1126-9.
Shen, R., et al., Clinical characteristics and therapeutic analysis of 51 patients with Marjolin's ulcers. Exp Ther Med, 2015. 10(4): p. 1364-1374.
Borges, V.F., et al., Clinicopathologic characterization of squamous-cell carcinoma arising from pilonidal disease in association with condylomata acuminatum in HIV-infected patients: report of two cases. DCR, 2001. 44(12): p. 1873-1877.
Hollestein, L.M., E. de Vries, and T. Nijsten, Trends of cutaneous squamous cell carcinoma in the Netherlands: increased incidence rates, but stable relative survival and mortality 1989-2008. Eur J Cancer, 2012. 48(13): p. 2046-53.
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