A RARE COMPLICATION IN PILONIDAL SINUS DISEASE: MALIGN DEGENEREATION


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ÖZDEMİR A.

II. BASKENT INTERNATIONAL CONFERENCE ON MULTIDISCIPLINARY STUDIES, Ankara, Turkey, 24 - 25 February 2022, pp.10-11

  • Publication Type: Conference Paper / Summary Text
  • City: Ankara
  • Country: Turkey
  • Page Numbers: pp.10-11
  • Recep Tayyip Erdoğan University Affiliated: Yes

Abstract

ABSTRACT

Pilonidal disease is a benign disease with chronic recurrent inflammation frequently seen in men. It is most commonly found in the sacrococcygeal region. It can also be seen in many places such as the umbilicus and axilla.

Malignant degeneration is a rare complication mainly observed in chronic, recurrent and untreated primary pilonidal disease and is associated with poor prognosis. Malignant degeneration is extremely rare and occurs in about 0.1% of cases. It is usually diagnosed incidentally in the excision materials. The most common type of malignancy is squamous cell carcinoma (90%). Basal cell carcinoma and adenocarcinoma are less common.

Wide excision with tumor-free margins is the preferred treatment. The efficacy of radiotherapy and chemotherapy is limited.

Our cases were two male patients aged 50 and 52 years. In both patients, the disease course was more than approximately 15 years. Both patients had fistula openings in the intergluteal sulcus and gluteal region. Peripheral LAP was not palpated. Both patients were repaired using the wide excision and flap method. The pathology results of both patients revealed squamous cell carcinoma. One of the patients who was referred to the postoperative oncology clinic could not be followed up because he went out of the province. The other patient is being followed up by oncology after surgical resection and did not receive adjuvant treatment.

In conclusion, pilonidal sinus is a benign disease and its malignancy rate is quite low. However, it should be kept in mind that malignancy may develop after recurrent episodes of inflammation that have not received long-term treatment. Especially in the presence of widespread sinus openings and inflammation around its current location, malignancy should be considered. The mainstay of treatment is wide surgical excision. The efficacy of adjuvant treatments is limited. Although abscess drainage and antibiotic therapy can be used in its treatment, total excision should be performed due to the risk of malignancy.

Key words: pilonidal sinus, malignant degeneration, SCC