Pilonidal disease specimens of 905 patients revealed no malignancy, however we still insist on histopathological examination

Yüksel, Mehmet Eren; Ordu, Melike

doi:10.5455/annalsmedres.2019.11.707

Cited by 6 publications

(7 citation statements)

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“…Our findings of no malignancy in specimens sent for histological analysis is consistent with the experience of others 4,5 . No carcinomas were reported in 86 333 cases of pilonidal sinus disease treated during the World War II.…”

Section: Discussionsupporting

confidence: 92%

Pilonidal sinus: is histological examination necessary?

Otutaha

Park

Xia

et al. 2020

ANZ Journal of Surgery

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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.

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Section: Discussionsupporting

confidence: 92%

Pilonidal sinus: is histological examination necessary?

Otutaha

Park

Xia

et al. 2020

ANZ Journal of Surgery

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“…Yüksel et al drew attention to the increased use of minimally-invasive approaches for the treatment of pilonidal sinus, such as phenol obliteration, fibrin glue application, and video-assisted resection. In these cases, no biopsies are taken and no specimens are sent to pathology, which may regularly miss microscopic foci of malignant transformation [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Demographic overview of pilonidal sinus carcinoma: updated insights into the incidence

Safadi

Dettmer

Berger³

et al. 2023

Int J Colorectal Dis

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Purpose There are only rough estimates of the worldwide incidence of pilonidal sinus carcinoma. The purpose of the study is to explore the demographic characteristics of this disease and to provide more precise information about its incidence. Methods The study included questioning the surgeons and pathologists in Germany in addition to a literature research. The literature investigation included all published articles about pilonidal carcinoma in all languages. The questionnaire included 1050 pathologists and all 834 hospitals with a surgical division in Germany. The outcome measures included the total number of cases, the language of publication, gender, age, country of origin, interval until the diagnosis of carcinoma, and reported incidence based on local studies. Results From 1900 to 2022, we found 140 cases of pilonidal sinus carcinoma in 103 articles. The investigation revealed two additional unpublished cases from Germany. The male-to-female ratio was 7.75:1. The countries with the most cases were the USA (35 cases, 25.0%), Spain (13 cases, 9.3%), and Turkey (11 cases, 7.6%). The average age was 54.0 ± 11.8 years and the interval between the diagnosis of the disease and the development of carcinoma was 20.1 ± 14.1 years. There was a parallel increase in reported cases of pilonidal sinus disease and pilonidal carcinoma over the last century. The reported incidence varied from 0.03% to 5.56%. The worldwide calculated incidence equaled 0.17%. Conclusion Due to underreporting and other causes, the incidence of carcinoma emerging on the background of pilonidal sinus disease is higher than reported.

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“…Phenol application is a simple procedure that can be performed with local anesthesia but requires patience for both the surgeon and the patient. Studies have reported successful treatment of the pilonidal sinus at a rate of 70-95% in 14-56 months (18). Pit-picking and sinus cavity destruction with laser or silver nitrate are other minimally invasive methods (12,19); improvement in pit excision has been reported at a rate of 79% (20), whereas the success rate via laser ablation is reported as 80-90% (11).…”

Section: Discussionmentioning

confidence: 99%

“…Other diagnoses included epidermoid carcinoma, basal cell carcinoma, and malignant degeneration. Besides, there are also series without malignancy (8,18). In our clinic, a total excision plus flap (Limberg or Karydakis) operation was performed in all 1971 patients, with routine histopathological examination performed for medico-legal reasons.…”

Section: Discussionmentioning

confidence: 99%

Sakrokoksigeal Pilonidal Sinüs Spesmenlerinde Patolojik Değerlendirme Gerekli midir?

Uylaş¹,

Gündoğdu²

2021

Osmangazi̇ Journal of Medicine

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In some surgical methods, the cavity of the sacrococcygeal pilonidal sinus remains in the patient. This situation leads us to question the necessity of routine pathological examination. Patients undergoing surgical excision for sacrococcygeal pilonidal sinus between January 2016 and March 2020 at Gaziantep Dr. Ersin Arslan Training and Research Hospital were retrospectively screened. Patients with pilonidal sinus in the non-sacrococcygeal region and patients with minimally invasive treatment and without histopathological examination were excluded. Gender, age, operation notes, and pathology results of the patients were analyzed. For all patients, an excision plus flap (Limberg or Karydakis) procedure was performed and the specimen was sent to routine histopathological examination. Of 1971 patients who underwent surgery for sacrococcygeal pilonidal sinus, 1551 (79%) were male and 420 (21%) were female, with an average age of 24 years (13-66). None of the pathological findings revealed any malignancy. The rate of malignancy reported in the literature is not in concordance with minimally invasive procedures in which pathology samples are not taken. Except in cases of prolonged duration of disease, elderly age, macroscopic suspicion, or recurrence, we believe that routine pathological examination of the pilonidal sinus may be unnecessary.

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Pilonidal disease specimens of 905 patients revealed no malignancy, however we still insist on histopathological examination

Cited by 6 publications

References 0 publications

Pilonidal sinus: is histological examination necessary?

Pilonidal sinus: is histological examination necessary?

Demographic overview of pilonidal sinus carcinoma: updated insights into the incidence

Sakrokoksigeal Pilonidal Sinüs Spesmenlerinde Patolojik Değerlendirme Gerekli midir?

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