Squamous-cell carcinoma arising in a pilonidal sinus: About a case successfully treated by radiotherapy

Abstract

Author(s): Fatima Zahra Farhane*, Zenab Alami, Sara Amrani Joutei, Wissal Hassani and Touria Bouhafa

Introduction: Pilonidal sinus is a benign inflammatory disease characterized by fistulas with exudative discharge. This disease is commonly seen in areas rich in hair follicles that penetrate the skin under direct pressure such as the sacrococcygeal region in the predominantly male population. Squamous cell carcinoma is a rare complication of pilonidal disease. Carcinoma in pilonidal disease mainly arises after 15-year disease history. The signs of malignant change are induration, rapid growth and sharp pain in ulcerated tumour. It can be detected incidentally on post-excisional histopathology. Wide excision with tumour-free margins remains the treatment of choice.

Case report: We present a case of a 45 years old-man operated for the pilonidal sinus with discovery on the surgical specimen of a squamous cell carcinoma without idea on resection limits. The patient, who refused revision surgery, had presented a tumour progression becoming unresectable, thus he had received radiotherapy with concomitant chemotherapy with a complete clinical and radiological response of the tumour.

Conclusion: the treatment by radiotherapy and chemotherapy as radio sensitizer can be proposed in unresectable locally advanced squamous cell carcinoma arising over pilonidal sinus.

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