Chronic hidradenitis suppurativa and perianal mucinous adenocarcinoma. A case report
Isabel C Chulvis do Val1, Gutemberg L Almeida Filho, Adriana Corrêa
1Vulvar Pathology Unit, Institute of Gynecology, Federal University of Rio de Janeiro and Pathology Unit, Andarai Hospital, Health Minister, Rio de Janeiro, Brazil. isabeldoval@uol.com.br
Background:
Hidradenitis is a chronic and suppurative inflammation of the apocrine sudoriparous glands. When located in the genital and perianal regions, it may be associated with cancer. This is the first case report of hidradenitis suppurativa in the vulvar region associated with perianal mucinous adenocarcinoma.
Case:
The patient was a 48-year-old woman who presented with extensive hidradenitis suppurativa in the vulvar and perianal regions. She had a 10-year history of hidradenitis suppurativa, previously managed at other institutions, with no satisfactory response. She underwent a simple vulvectomy and resection of the perianal region. A diagnosis of perianal mucinous adenocarcinoma was made. An abdominoperineal resection was performed, followed by a combination of adjuvant radiation. The patient was well for 1 year after treatment. The disease later recurred in the perianal region and resulted in the patient's death.
Conclusion:
Treatment of hidradenitis suppurativa of the genital and perianal regions may be clinical or surgical, depending on the extensiveness and seriousness of the disease. Surgery remains the treatment of choice for chronic and severe cases. Association with malignancy, although very rare, is the most serious complication.
