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Scrotal wall necrosis after hipec using mitomycin-c: Case report and review of the literature
Mriam Attalla El Halabieh1, Claudio Lodoli1, Federica Ferracci1
1Surgical Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Italy.
Introduction:
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a current treatment option for peritoneal carcinosis (PC) after cytoreductive surgery (CRS). Genital skin alterations are rare complications reported variously after HIPEC using Mitomycin-C.
Presentation Of Case:
A 42-year-old man with a diagnosis of stage IV colorectal cancer underwent CRS and HIPEC using mitomycin-C. On postoperative day 75, he developed scrotal wall necrosis not responding to any medical treatment. After he underwent surgery to remove the necrotic tissue and primarily suture the scrotal wound with success.
Discussion:
Genital skins disorders are rarely drugs-related effects and few cases after HIPEC using Mitomycin-C are reported in literature. The most accepted hypothesis to explain the occurrence of scrotal ulcers after CRS and HIPEC is the extravasation reaction to Mitomycin-C that inhibits wound healing and induces skin necrosis.
Conclusion:
Correct diagnosis and immediate surgical debridement are the preferable management.
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