Management of Squamous Cell Carcinoma in a Chronic Sacrococcygeal Pilonidal Cyst: A Case Report

Author Info

Charbel Aoun Hani Maalouf Saleem Abdel Backi Toufic Saber William Watfa Ziad El Rassi

Corresponding Author

Ziad El Rassi
Professor of General Surgery, Head of General Surgery Department, Saint Georges Hospital University Medical Center, University of Balamand, Beirut, Lebanon

A B S T R A C T

Introduction: Pilonidal disease is a chronic inflammatory process resulting from impaction of natal cleft hair into the subcutaneous tissues creating an abscess or a draining sinus over the sacrococcygeal area. Malignant transformation occurs in around 0.1%, mainly into squamous cell carcinoma (SCC) type. Wide excision with tumor-free margins remains the treatment of choice. Multiple closure techniques were settled and the best one ought to be chosen in a context malignancy and future radiological treatment. Case Presentation: We describe the management of a case of a 69-year-old male with chronic pilonidal disease, recurrent after 25 years found on final pathology to undergo malignant transformation into SCC. Wide and aggressive excision were performed with new margins and with periosteal excision of the sacrum and coccyx. rotational myocutaneous gluteal flap was done for closure of the wound in order to ensure better satisfactory esthetic results without a delay in future treatment. Conclusion: The progression of a chronic pilonidal disease into SCC is a rare but serious complication. The diagnosis is confirmed by biopsies. Workup for metastasis should be made before aggressive surgical excision. Oncoplastic surgeries is recommended for satisfactory results. Routine follow-up postoperatively should be considered due to high rate of recurrence by physical examination and imaging.

Article Info

Article Type

Case Report

Publication history

Received: Tue 26, May 2020
Accepted: Tue 09, Jun 2020
Published: Fri 19, Jun 2020

Copyright

© 2023 Ziad El Rassi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2020.06.18