Fasching M C, Meland N B, Woods J E, Wolff B G
Section of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Dis Colon Rectum. 1989 Feb;32(2):153-8. doi: 10.1007/BF02553830.
Squamous-cell carcinoma arising from a pilonidal sinus tract is an unusual complication of a common condition. Approximately 36 cases of carcinoma related to pilonidal disease have been reported in the literature. Wide excision with tumor-free margins has yielded five-year disease-free states in 55 percent of patients. Recurrence rates have been 44 percent to 50 percent in several large series. Regional (inguinal) nodal metastasis occurs in 14 percent of patients, heralding a dismal prognosis. Radiation and chemotherapy are of minimal palliative value. Reconstruction of these patients has consisted of split-thickness skin grafts or local cutaneous and myocutaneous flaps. Some authors have allowed healing by secondary intention. A case of squamous-cell carcinoma arising in a chronic pilonidal sinus tract is reported. Local recurrence required an extensive resection resulting in a large sacral/perineal defect. A single-stage reconstruction of this defect with multiple muscle and musculocutaneous flaps is described.
起源于藏毛窦道的鳞状细胞癌是一种常见疾病的罕见并发症。文献中已报道了约36例与藏毛疾病相关的癌病例。切缘无瘤的广泛切除使55%的患者获得了五年无病状态。在几个大型系列研究中，复发率为44%至50%。14%的患者发生区域（腹股沟）淋巴结转移，预示预后不佳。放疗和化疗的姑息价值极小。这些患者的重建包括断层皮片移植或局部皮瓣及肌皮瓣。一些作者允许二期愈合。本文报道了1例发生于慢性藏毛窦道的鳞状细胞癌病例。局部复发需要广泛切除，导致巨大的骶骨/会阴缺损。描述了用多个肌肉和肌皮瓣对该缺损进行一期重建的方法。
