Losanoff Julian E, Sochaki Paula, Khoury Nabiha, Levi Edi, Salwen Walter A, Basson Marc D
Department of Surgery, John D. Dingell VAMC and Department of Surgery, Michigan State University, Lansing, Michigan, USA.
Am Surg. 2011 Nov;77(11):1449-53.
A 69-year-old male patient underwent excision of hidradenitis suppurativa (HS) affecting both gluteal areas and the perineum. The perineal specimen contained a 1-cm superficially invasive, well-differentiated keratinizing squamous cell carcinoma. The patient was free of recurrence 1 year after surgery. A 66-year-old male patient was diagnosed with massive perineal HS more than 40 years previously. More than 30 abscesses and suppurative sinus tracts were surgically treated over the years. He eventually died of unresectable pelvic squamous carcinoma. Search of the literature and available bibliography revealed 47 retrospective studies of skin carcinoma arising in HS since 1959, including a total of 64 patients together with the two patients treated by our team. Squamous cell carcinoma is a rare but potentially fatal complication of HS. Surgery is the only known treatment method that provides a real chance for cure for both HS and a carcinoma that complicates it. HS must be treated early with complete excision to avoid chronic progression of the disease that can cause cancerous degeneration. A high index of suspicion, early tissue diagnosis, and immediate referral for radical surgery carry the only hope for cure in those whose HS harbors malignancy.
一名69岁男性患者接受了双侧臀部和会阴部位化脓性汗腺炎（HS）的切除手术。会阴部位的标本中含有一个1厘米大小的浅表浸润性、高分化角化鳞状细胞癌。该患者术后1年无复发。一名66岁男性患者40多年前被诊断为广泛性会阴HS。多年来，超过30处脓肿和化脓性窦道接受了手术治疗。他最终死于无法切除的盆腔鳞状细胞癌。检索文献和现有参考书目发现，自1959年以来有47项关于HS中发生皮肤癌的回顾性研究，包括总共64例患者以及我们团队治疗的2例患者。鳞状细胞癌是HS一种罕见但可能致命的并发症。手术是唯一已知的治疗方法，为HS及其并发的癌症提供了真正的治愈机会。必须尽早对HS进行彻底切除治疗，以避免疾病的慢性进展导致癌变。对于HS伴有恶性肿瘤的患者，高度怀疑、早期组织诊断以及立即转诊进行根治性手术是治愈的唯一希望。
