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DOI: 10.1055/s-0045-1808650
SQUAMOUS CELL CARCINOMA ASSOCIATED WITH CHRONIC HIDRADENITIS SUPPURATIVA: CASE REPORT AND LITERATURE REVIEW
Introduction Hidradenitis Suppurativa (HS) is a chronic inflammatory disorder that affects the pilosebaceous unit, and Squamous Cell Carcinoma (SCC), also known as epidermoid carcinoma, may arise as a complication.
Case Presentation A 58-year-old male, smoker, obese, and with type 2 diabetes, initially followed by the dermatology team for follicular occlusion syndrome manifested by HS, was referred to the coloproctology service due to the progression of a lesion in the perianal region near the HS lesions. On physical examination, an ulcerated, vegetative, painful, friable lesion was found in the right perianal region, consistent with SCC in the HS scar. Pelvic MRI revealed a neoplastic tissue proliferation at the right anal margin measuring 5.2 × 1.2 × 3.0 cm, with signs of neoplastic involvement of the internal and external anal sphincters. A biopsy of the lesion confirmed SCC (T3N1M0) in the HS scar. The patient underwent chemotherapy combined with radiotherapy; however, lesions recurred. Due to this, abdominoperineal amputation of the rectum was indicated. The patient remains under outpatient follow-up, disease-free for 2 years.
Discussion Studies have shown that patients with chronic HS have a higher risk of developing SCC, especially when the perineal and gluteal regions are involved, though this is a rare occurrence. The standard protocol for SCC is chemoradiotherapy, aiming to preserve the anal sphincter by avoiding surgical procedures. Surgical intervention is reserved for cases that do not respond to chemoradiotherapy or for advanced cases where local resection alone is insufficient.
Conclusion The reported case follows the epidemiology of HS, mainly affecting males with chronic lesions in the perianal, gluteal, and perineal regions. These lesions can evolve severely and become refractory to non-invasive measures, requiring more aggressive surgery.
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No conflict of interest has been declared by the author(s).
Publication History
Article published online:
25 April 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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