Del Zingaro M, Boni A, Paladini A, Rossi De Vermandois J A, Ciarletti S, Felici G, Ursi P, Cirocchi R, Mearini E
G Chir. 2019 Nov-Dec;40(6):481-496.
Fournier's gangrene is a rare and potentially lethal condition. Previously described as an idiopathic process, this necrotising fasciitis is secondary to infection and in 95% of cases the cause arises from ano-rectum (30-50%), uro-genitalia (20-40%) or genital skin (20%). Cancer could lead to a Fournier's gangrene thanks a Romacompromised host immunity condition. In the past the rate of death was high ranging from 20% to 80%, while currently mortality is decreasing to 10%. We report a case of a 76-years-old man with Fournier's Gangrene due to locally advanced prostate cancer. The multimodal therapeutic management included broad-spectrum antibiotic therapy, intravenous fluid resuscitation and surgical debridement that was delayed by the will of the patient. To our knowledge, this is the first case of Fournier's gangrene caused by prostate cancer without common predisposing factors. In order to improve the knowledge about this rare disease, we performed a narrative review of the literature.
福尼尔坏疽是一种罕见且可能致命的疾病。以前被描述为特发性疾病,这种坏死性筋膜炎继发于感染,95%的病例病因源于肛门直肠(30 - 50%)、泌尿生殖系统(20 - 40%)或生殖器皮肤(20%)。癌症可能由于宿主免疫功能受损导致福尼尔坏疽。过去死亡率很高,在20%至80%之间,而目前死亡率降至10%。我们报告一例76岁男性因局部晚期前列腺癌导致福尼尔坏疽的病例。多模式治疗管理包括广谱抗生素治疗、静脉补液复苏以及因患者意愿而延迟的手术清创。据我们所知,这是首例无常见易感因素的前列腺癌导致福尼尔坏疽的病例。为提高对这种罕见疾病的认识,我们对文献进行了叙述性综述。