Mucinous adenocarcinoma associated with chronic suppurative hidradenitis: Report of a case and review of the literature. (2016)

• Record Type: Journal Article
• Authors: Mukai, Natalia; Pinheiro, Lílian Vital; Ayrizono, Maria de Lourdes Setsuko; Barreiro, Guilherme Cardinali; Kharmandayan, Paulo; Akinaga, Mariana Hanayo; Bento, Adriano Mesquita; Martinez, Carlos Augusto Real; de Carvalho, Rita Barbosa; Ward, Marc; Coy, Cláudio Saddy Rodrigues; Leal, Raquel Franco
• Is Part Of: International journal of surgery case reports. Volume 26(2016)
• Page Start: 12
• Page End: 16
• Publication Date: 2016
• Subjects: Mucinous adenocarcinoma -- Chronic suppurative hidradenitis -- Case report -- Colorectal surgery; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.06.039
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Mucinous adenocarcinoma associated with suppurative hidradenitis is extremely rare. Magnetic resonance imaging findings help in the diagnosis of mucinous adenocarcinoma. The surgery is highly complex, and even in a tertiary hospital, complications may occur. Abstract: Introduction: Chronic suppurative hidradenitis (CSH) is a benign condition that can affect the perineal region and often leads to the formation of abscesses and fistulas. It is rare for CSH to undergo malignant degeneration into mucinous adenocarcinoma. Presentation of case: We report a case of a 55-year-old male patient with perineal CSH who suffered worsening long-term pain despite multiple surgical procedures to alleviate his symptoms. Pelvic magnetic resonance imaging (MRI) showed multiloculated cystic lesion on the left side wall of the distal rectum with gluteal extension. Pathological examination revealed mucinous adenocarcinoma. The patient underwent an abdominoperineal resection (APR) of the rectum with cutaneous muscle flap reconstruction. Although histopathological sections showed clear margins, the tumor recurred 6 months following surgery. Discussion: Perineal mucinous adenocarcinoma arising in a patient with CSH is an extremely rare condition. This diagnosis is often difficult, due to the paucity of signs of malignant degeneration as well as the rarity of the disease itself. Surgical resection of the lesions is a well-established approach. In this case, diagnosing the tumor at such a late stage likely compromised his outcome. Conclusion: Malignant degeneration to mucinous adenocarcinoma must be suspected in patients with a history of long-term CSH. In such cases, local biopsies and a radiological examination, such as MRI can help in the diagnosis.