Vol.14, No 3, 2007 pp. 133 - 137
UC 616.594-002:616.5-006
CARCINOMA ARISING IN PILONIDAL DISEASE
– REPORT OF TWO CASES
Predrag Kovacevic1, Milan Visnjic1,
Milica Vukadinovic2, Tatjana Kovacevic3,
Dragan Mihajlovic4
1Clinical Center Nis, Clinic for Plastic
and Reconstructive Surgery
2Medical Faculty Nis
3Clinical Center Nis, Clinic for Anesthesia
and Reanimation
4Clinical Center Nis, Clinic for General
Surgery
E-mail: tpkovacevic@eunet.yu
Summary. Squamous cell skin carcinoma is a rare complication of
pilonidal disease. The signs of malignant change are induration, rapid
growth and sharp pain in ulcerated tumor. Men are mostly involved. Histology
defined highly differentiated squamous carcinoma in one and a bad differentiation
in the other. Carcinoma in pilonidal disease mainly arises after 15 year
disease history. Two men were operated on for this carcinoma at Surgical
clinic of Nis. After biopsy, carcinoma was operated radically (large excision)
and margins needed to be clean. Immediate reconstruction was performed
with skin grafts and musculocutaneous gluteus maximus peddicled flap. Postoperative
radiation therapy was performed. One patient is disease free after 3 years,
but other died 9 months after surgery. The primary prevention from carcinoma
is surgery for early pilonidal disease. Large surgical ressection and clean
margins could obtain satisfactory results.
Key words: Pilonydal disease,
skin carcinoma, surgery
KARCINOM NASTAO IZ PILONIDALNOG SINUSA
– PRIKAZ DVA SLUČAJA
Kratak sadržaj: Karcinom na pilonidalnom sinusu je retka komplikacija
bolesti. Sumnju hirurga treba da pobudi induracija i rast ulcerisanog tumora
kao i pojava jakih bolova. Češće se javlja kod muškaraca. Patohistološki
je dobro diferentovan planocelularni karcinom kod jednog, a kod drugog
loše diferentovan. Ovaj tumor nastaje kod pacijenata sa dugogodišnjom
anamnezom (preko 15 godina). Dva pacijenta sa pilonidalnim karcinomom su
operisana u Hirurškoj klinici u Nišu. Hirurško lečenje pacijenta sa
karcinomom na pilonidalnom sinusu zaheva široku radikalnu hiruršku eksciziju
uz kontrolu resekcionih ivica i primarnu rekonstrukciju defekta.Rekonstrukcija
defekta je rađena transplantatima kože i režnjevima. Postoperativno
je sprovedena zračna terapija. Jedan bolesnik posle 3 godine nema znakove
za recidiv niti metastaze, a drugi bolesnik je umro nakon 9 meseci od operacije.
Najbolja prevencija karcinoma nastalog iz pilonidalnog sinusa je hirurško
lečenje pilonidalne bolesti u ranoj fazi. Radikalna hirurška ekscizija
sa kontrolom ivica resekcije može obezbediti uspeh u lečenju.
Ključne reči: pilonidalna
bolest, karcinom kože, hirurgija
