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Carcinoma arising in pilonidal sinuses

S J Pilipshen, G Gray, E Goldsmith

    Annals of Surgery
    |April 1, 1981
    PubMed
    Summary
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    Pilonidal carcinoma, a rare complication of pilonidal disease, is best treated with wide surgical excision. Early detection and treatment of this squamous cell carcinoma improve survival rates.

    Area of Science:

    • Oncology
    • Dermatology
    • Surgical Pathology

    Background:

    • Pilonidal disease is a chronic inflammatory condition.
    • Pilonidal carcinoma is an infrequent but serious complication.

    Observation:

    • The condition predominantly affects men and often presents as well-differentiated squamous cell carcinoma.
    • Longstanding inflammation is a key indicator for suspicion.

    Findings:

    • Wide surgical excision during the initial procedure, after local wound care, offers the best chance for a five-year survival.
    • Delayed wound closure using flaps or grafts is recommended.
    • Inguinal lymph node biopsy is advised for palpable nodes, though metastasis indicates a poor prognosis.

    Implications:

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    • Optimal treatment involves prompt surgical intervention.
    • Further research is needed to understand occult metastasis and the efficacy of chemotherapy and radiation therapy for pilonidal carcinoma.