Bacil 'Otutaha1, Brittany Park2, Weisi Xia1, Andrew G Hill1,2. 1. Department of Surgery, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand. 2. Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
Abstract
BACKGROUND: Pilonidal sinus is a common pathology occurring in a number of sites including the gluteal cleft between the buttocks. Surgery is the principal mode of treatment with a variety of techniques proposed to cure the disease and prevent recurrence. The rate of malignant degeneration is estimated at 0.1% in patients with chronic pilonidal disease. A case series study of pilonidal sinus found that most patients with malignancy were over the age of 50 years and had had chronic pilonidal disease for several years. This study aimed to review the value of histological analysis of pilonidal sinus specimens. METHODS: A retrospective observational study was conducted of all patients who have undergone pilonidal sinus excision by the Department of General Surgery at Counties Manukau District Health Board in the past 10 years. RESULTS: This study reviewed 1324 admissions with a pilonidal disease requiring surgical management. There were 325 pilonidal resections with 320 histological specimens analysed. Pilonidal sinus was detected in 312 specimens, eight others were benign and there were no specimens with malignancy. CONCLUSION: No cases of malignancy were found in all pilonidal specimens that were sent for histological review. Routine histological examination of pilonidal sinus specimens appears to be unnecessary; however, it should be considered in patients over the age of 50 years.
BACKGROUND: Pilonidal sinus is a common pathology occurring in a number of sites including the gluteal cleft between the buttocks. Surgery is the principal mode of treatment with a variety of techniques proposed to cure the disease and prevent recurrence. The rate of malignant degeneration is estimated at 0.1% in patients with chronic pilonidal disease. A case series study of pilonidal sinus found that most patients with malignancy were over the age of 50 years and had had chronic pilonidal disease for several years. This study aimed to review the value of histological analysis of pilonidal sinus specimens. METHODS: A retrospective observational study was conducted of all patients who have undergone pilonidal sinus excision by the Department of General Surgery at Counties Manukau District Health Board in the past 10 years. RESULTS: This study reviewed 1324 admissions with a pilonidal disease requiring surgical management. There were 325 pilonidal resections with 320 histological specimens analysed. Pilonidal sinus was detected in 312 specimens, eight others were benign and there were no specimens with malignancy. CONCLUSION: No cases of malignancy were found in all pilonidal specimens that were sent for histological review. Routine histological examination of pilonidal sinus specimens appears to be unnecessary; however, it should be considered in patients over the age of 50 years.
Authors: Sara Vertaldi; Pietro Anoldo; Grazia Cantore; Alessia Chini; Anna D'Amore; Maria D'Armiento; Nicola Gennarelli; Francesco Maione; Michele Manigrasso; Alessandra Marello; Pietro Schettino; Carmen Sorrentino; Loredana M Sosa Fernandez; Giovanni D De Palma; Marco Milone Journal: Front Surg Date: 2022-03-03