Volume 5, Issue 1, March 2020, Page: 5-9
Therapeutic Attitude in the Malignification of Pilonidal Cyst: Radical Treatment Associating Intraoperative Radiotherapy
Natalia Noblejas Quiles, Department of Radiation Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Virginia Morillo Macías, Department of Radiation Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Araceli Mayol Oltra, Department of General Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Fernando Ibáñez Palacín, Department of General Surgery, Hospital de Vinaroz, Castellon, Spain
Jorge Molina Saera, Department of Medical Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Rafael Lozoya Albalar, Department of General Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Enrique Boldó Roda, Department of General Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Stephane Antonio De Francia Cachon, Department of Plastic Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
María Eloísa Villaverde Domenech, Department of Plastic Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Isabel Busquier Hernández, Department of Medical Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Carlos Ferrer Albiach, Department of Radiation Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
Received: Dec. 7, 2019;       Accepted: Dec. 26, 2019;       Published: Jan. 8, 2020
DOI: 10.11648/j.ijcocr.20200501.12      View  607      Downloads  160
Abstract
Malignant degeneration on pilonidal cyst is an infrequent entity: less than 70 cases have been described in the literature. Predominantly in males around 50-60. Very slow evolution until its malignancy. Predilection for the sacrococcygeal area and epidermoid histology. Infrequent distant dissemination despite the important local extension of the primary tumor. Similar morphological and histological characteristics to anal carcinomas, using schemes of treatment based on radiotherapy and chemotherapy with radical intention according to locoregional and distance extension, associating subsequent surgery depending on the response. We describe a case of this pathology and its therapeutic management based on the literature review available. We present the case of a 70-year-old man with a pilonidal cyst malignancy in the sacrococcygeal region. Locally advanced and unresectable disease at diagnosis with skin, muscle, lymphatic and bone involvement. Pathological confirmation diagnosis established after thick needle biopsy, with a well-differentiated squamous cell carcinoma. It was decided to administer chemotherapy and radiotherapy treatment and, depending on the response evaluated by nuclear magnetic resonance, excision and/or intraoperative radiotherapy in the area of microscopic risk disease. In a second time, reconstruction using glute flaps. Early diagnosis and treatment are essential to improve the unfortunate prognosis. Surgery with curative intention is the standard of care according to locoregional extension in association with radiotherapy and chemotherapy if adverse factors or unresectable disease. In order to enhance local control, dose has been scaled allowing, besides, to minimize the acute toxicity derived from the treatment.
Keywords
Malignancy of Pilonidal Cyst, Radiotherapy, Intraoperative Radiotherapy, Neoadjuvant Treatment, Sacrococcygeal Area, Surgery
To cite this article
Natalia Noblejas Quiles, Virginia Morillo Macías, Araceli Mayol Oltra, Fernando Ibáñez Palacín, Jorge Molina Saera, Rafael Lozoya Albalar, Enrique Boldó Roda, Stephane Antonio De Francia Cachon, María Eloísa Villaverde Domenech, Isabel Busquier Hernández, Carlos Ferrer Albiach, Therapeutic Attitude in the Malignification of Pilonidal Cyst: Radical Treatment Associating Intraoperative Radiotherapy, International Journal of Clinical Oncology and Cancer Research. Vol. 5, No. 1, 2020, pp. 5-9. doi: 10.11648/j.ijcocr.20200501.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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