{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T08:12:35Z","timestamp":1794039155151,"version":"4.8.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T00:00:00Z","timestamp":1587945600000},"content-version":"vor","delay-in-days":117,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pilonidal sinus is a very common disease. Malignant transformation occurs in 0,1% of patients. We present a case of squamous cell carcinoma arised from recurrent pilonidal disease, managed by multimodal treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>We present a 70-year-old man with chronic pilonidal sinus. Inflammation had worsened in previous months and exploration revealed a large ulcerative mass which biopsy showed a squamous cell carcinoma. CT scan and MRI imaging showed tumoral invasion of the coccyx and both gluteus major muscles. Neoadjuvant radiotherapy, chemotherapy as radiosensitizer and surgery with intraoperative radiotherapy was decided in the multidisciplinary tumor committee. Post neoadjuvant therapy MRI showed partial response with a decrease of the mass but persistence of the coccyx infiltration.<\/jats:p>\n                    <jats:p>Surgery consisted in en-bloc resection of the tumor with presacral tissues, coccyx and partial gluteal resection. Intraoperative radiotherapy was administered over the sacrum and in the bed of the coccyx resection. One week later, reconstructive surgery was practiced using a latissimus dorsi free flap, advancement of gluteal flaps and skin graft. Histological examination showed no residual tumor. The patient is currently asymptomatic and he has a satisfactory quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Although squamous cell carcinoma is rare, it must be suspected in patients with recurrent pilonidal disease. Diagnosis is done by histological examination of biopsies. This type of tumors have a high local recurrence rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We propose a multimodal treatment that includes neoadjuvant radiotherapy and chemotherapy as radiosensitizer and surgery plus intraoperative radiotherapy with the aim to decrease local recurrence rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.04.043","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:17:19Z","timestamp":1589156239000},"page":"172-177","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Squamous cell carcinoma over pilonidal chronic disease. A new therapeutic approach"],"prefix":"10.1097","volume":"70","author":[{"given":"Mayol A.","family":"Oltra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bold\u00f3 E.","family":"Roda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lozoya R.","family":"Albacar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morillo V.","family":"Macias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobleja N.","family":"Quiles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-40-20260114","first-page":"446","article-title":"Recurrent squamous cell carcinoma arising in a neglected pilonidal sinus: report of a case and literature review","volume":"7","author":"Ramazan","year":"2014","journal-title":"Int. J. Exp. Med"},{"key":"R2-40-20260114","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s00268-011-1333-y","article-title":"Comparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery","volume":"36","author":"Okis","year":"2012","journal-title":"World J. Surg"},{"key":"R3-40-20260114","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s10151-011-0799-9","article-title":"Modifies Limberg transposition flap in the treatment of pilonidal sinus disease","volume":"16","author":"Kaya","year":"2012","journal-title":"Tech. Coloproctol"},{"key":"R4-40-20260114","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.suc.2009.09.006","article-title":"Evaluation and management of pilonidal disease","volume":"90","author":"Humphries","year":"2010","journal-title":"Surg. Clin. N. Am"},{"key":"R5-40-20260114","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1684\/ejd.2009.0705","article-title":"Squamous cell carcinoma related to long standing pilonidal-disease","volume":"19","author":"Chatzis","year":"2009","journal-title":"Eur. J. Dermatol"},{"key":"R6-40-20260114","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.surg.2007.08.018","article-title":"Malignant transformation of a pilonidal sinus","volume":"145","author":"Sharma","year":"2009","journal-title":"Surgery"},{"key":"R7-40-20260114","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12957-017-1129-0","article-title":"Squamous cell carcinoma arising from chronic sacroccocygeal pilonidal disease: a case report","volume":"15","author":"Michalopoulos","year":"2017","journal-title":"World J. Surg. Oncol"},{"key":"R8-40-20260114","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/j.1445-2197.2011.05989.x","article-title":"Don\u2019t sit on chronic inflammation","volume":"82","author":"White","year":"2012","journal-title":"ANZ J. Surg"},{"key":"R10-40-20260114","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s10434-001-0011-y","article-title":"Treatment of malignancy arising in pilonidal disease","volume":"8","author":"De Bree","year":"2001","journal-title":"Ann. Surg. Oncol"},{"key":"R13-40-20260114","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1524-4725.1984.tb01209.x","article-title":"Squamous cell carcinoma arising in a pilonidal sinus: a case report and review of the literature","volume":"10","author":"Sagi","year":"1984","journal-title":"J. Dermatol. Surg. Oncol"},{"key":"R14-40-20260114","first-page":"731","article-title":"Carcinoma auf dem Boden des Dermoids","volume":"62","author":"Wolf","year":"1900","journal-title":"Arch. Klin. Chir"},{"key":"R15-40-20260114","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/00000637-199706000-00016","article-title":"Squampus cell carcinoma in perineal inflammatory disease","volume":"38","author":"Gur","year":"1997","journal-title":"Ann. Plast. Surg"},{"key":"R16-40-20260114","doi-asserted-by":"crossref","first-page":"164","DOI":"10.12659\/AJCR.892843","article-title":"Is histological examination necessary when excising a pilonidal cyst?","volume":"16","author":"Parpoudi","year":"2015","journal-title":"Am. J. Case Rep"},{"key":"R17-40-20260114","first-page":"407","article-title":"Degenerazione maligna di una cisti pilonidale. Caso clinic","volume":"80","author":"Tirone","year":"2009","journal-title":"Ann. Ital. Chir"},{"key":"R18-40-20260114","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1590\/abd1806-4841.20132140","article-title":"Carcinomatous degeneration of pilonidal cyst with sacrum destruction and invasion of the rectum","volume":"88","author":"Nunes","year":"2013","journal-title":"An. Bras. Dermatol"},{"key":"R19-40-20260114","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1007\/s10350-007-0267-9","article-title":"Malignant degeneration of pilonidal disease in an immunosuppressed patient: report of a case and review of the literature","volume":"50","author":"Malek","year":"2007","journal-title":"Dis. Colon Rectum"},{"key":"R20-40-20260114","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1080\/110241501750243888","article-title":"Malignant degeneration: an unsual complication of pilonidal sinus disease","volume":"167","author":"Pekmezki","year":"2001","journal-title":"Eur. J. Surg"},{"key":"R21-40-20260114","first-page":"506","article-title":"Carcinoma arising in pilonidaql sinuses","volume":"193","author":"Pilipshen","year":"1981","journal-title":"Ann. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220302352?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220302352?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.04.043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:35:36Z","timestamp":1768397736000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.04.043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":18,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.04.043","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}