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. 2019 Apr;45(4):519-526.
doi: 10.1097/DSS.0000000000001713.

Squamous Cell Carcinoma in Perineal, Perianal, and Gluteal Hidradenitis Suppurativa: Experience in 12 Patients

John J Kohorst  1 , Kabeer K Shah  2 , Christopher L Hallemeier  3 , Christian L Baum  1 , Mark D P Davis  1
Affiliations

Squamous Cell Carcinoma in Perineal, Perianal, and Gluteal Hidradenitis Suppurativa: Experience in 12 Patients

John J Kohorst et al. Dermatol Surg. 2019 Apr.

Abstract

Background: Few reports describe squamous cell carcinoma (SCC) arising in hidradenitis suppurativa (HS).

Objective: The 2 objectives were (1) to describe the clinical characteristics, pathologic findings, and postoperative outcomes of SCC in HS and (2) to assess whether human papillomavirus (HPV) is involved in the pathogenesis.

Materials and methods: Cases of SCC in HS were identified through institutional medical records (1976-2013) and the Rochester Epidemiology Project. Tumor specimens were assessed for HPV DNA/RNA with in situ hybridization.

Results: Twelve patients were identified (11 Caucasians and 9 men). All SCCs involved gluteal, perianal, or perineal skin; 1 patient had, in addition, involvement of the vagina. Surgical excision was performed on all 12 patients, 4 of whom had a colostomy. Mean duration of HS before SCC development was 28.5 years (range, 15-53 years). Mean follow-up was 4.3 years after surgical excision. Seven of 12 patients followed had postoperative SCC recurrence. Squamous cell carcinoma caused death despite wide surgical excision in these 7 patients. Of the remaining 5 patients, 4 are unknown and 1 who did not recur had an in situ SCC (Bowen disease carcinoma). Squamous cell carcinoma was not associated with high-risk or low-risk HPV.

Conclusion: Invasive SCC arising in HS carries a high risk of death.

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Figures

Figure 1.
Figure 1.
Squamous Cell Carcinoma (SCC) Arising in Hidradenitis Suppurativa (HS). A, Patient 7 at SCC diagnosis with 2 draining ulcers and a background of inflammatory HS. B, Patient 6, 1 month after SCC diagnosis from a 3×5-cm nodule involving the right side of the vulva, posterior vaginal wall, perineum, and perianal skin. C, Patient 8 after wide surgical excision, 6 months after initial SCC diagnosis. D, Patient 11 at SCC diagnosis with 2 ulcers and a background of inflammatory HS.
Figure 2.
Figure 2.
Squamous Cell Carcinoma (SCC) Arising in Hidradenitis Suppurativa (HS). Patient 6 with invasive, well-differentiated SCC arising in an adjacent fistula tract of HS (hematoxylin-eosin, original magnification ×100).
See this image and copyright information in PMC

Comment in

References

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