Filho Andrey Salgado Moraes, Pazin Giovanna Savoy, Genaro Lívia Moreira, Oliveira Priscila de Sene Portel, Ayrizono Maria de Lourdes Setsuko, Leal Raquel Franco
Colorectal Surgery Unit, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
Colorectal Surgery Unit, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
Int J Surg Case Rep. 2024 Oct;123:110271. doi: 10.1016/j.ijscr.2024.110271. Epub 2024 Sep 10.
Hidradenitis Suppurativa (HS) is a chronic inflammatory disorder that affects the pilosebaceous unit. Squamous Cell Carcinoma (SCC) can emerge as a complication.
A 58-year-old male patient with a history of smoking, obesity, and type 2 diabetes was initially managed by a dermatology team for Follicular Occlusion Syndrome manifesting as HS. Despite clinical treatment, the patient was referred to the Coloproctology Unit because of the development of a lesion in the perianal region near the HS lesions. Physical examination revealed an ulcerated, vegetative, painful, and friable lesion in the right perianal region consistent with SCC of the HS scar. The patient underwent chemotherapy and radiotherapy, but the lesions recurred, necessitating abdominoperineal amputation of the rectum.
Although rare, patients with chronic HS are at an increased risk of developing SCC, particularly in the perineal and gluteal regions. The standard treatment protocol for SCC in HS involves chemoradiotherapy with the aim of preserving the anal sphincter and avoiding surgery. Surgical intervention is reserved for patients that are unresponsive to chemoradiotherapy or for advanced cases in which local resection is insufficient.
This disease course aligns with the epidemiology of HS, which predominantly affects male individuals with chronic lesions in the perianal, gluteal, and perineal regions. Such lesions can progress severely, often resisting non-invasive treatments and requiring more aggressive surgical interventions.
化脓性汗腺炎（HS）是一种影响毛囊皮脂腺单位的慢性炎症性疾病。鳞状细胞癌（SCC）可能作为一种并发症出现。
一名58岁男性患者，有吸烟、肥胖和2型糖尿病史，最初由皮肤科团队治疗表现为HS的毛囊闭锁综合征。尽管进行了临床治疗，但由于HS病变附近的肛周区域出现病变，该患者被转诊至结直肠外科。体格检查发现右肛周区域有一个溃疡、赘生物、疼痛且易碎的病变，符合HS瘢痕的SCC。患者接受了化疗和放疗，但病变复发，需要进行直肠腹会阴切除术。
尽管罕见，但慢性HS患者发生SCC的风险增加，尤其是在会阴和臀区。HS中SCC的标准治疗方案包括放化疗，目的是保留肛门括约肌并避免手术。手术干预适用于对放化疗无反应的患者或局部切除不足的晚期病例。
该病程与HS的流行病学一致，HS主要影响肛周、臀区和会阴区域有慢性病变的男性个体。此类病变可能严重进展，常常抵抗非侵入性治疗，需要更积极的手术干预。
