Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
권호 표지
DOI QR코드

DOI QR Code

Fournier's Gangrene Induced by Rectal Cancer

  • Chi Hyeon Choi (Departments of Internal Medicine, Dong-A University College of Medicine) ;
  • Dong Wook Kim (Departments of Internal Medicine, Dong-A University College of Medicine) ;
  • Jong Yoon Lee (Departments of Internal Medicine, Dong-A University College of Medicine) ;
  • Jong Hoon Lee (Departments of Internal Medicine, Dong-A University College of Medicine) ;
  • Hye Ryeon Kim (Departments of Internal Medicine, Dong-A University College of Medicine)
  • Received : 2024.04.05
  • Accepted : 2024.04.19
  • Published : 2024.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Fournier's gangrene (FG) is a necrotizing fasciitis of the perianal, perineal, and genital regions, leading to necrosis of the fascia and subcutaneous tissue. It is a rare condition, particularly when induced by rectal cancer. Herein, we present a rare case in which FG was discovered incidentally during the physical examination of a patient who complained of general weakness. The patient was diagnosed with FG induced by rectal cancer with liver metastasis and underwent laparoscopic diverting loop ileostomy instead of abdominoperineal resection (APR). After 13 rounds of chemotherapy over 9 months, the condition of the rectal cancer partially improved. Furthermore, FG lesions showed improvement with this treatment plan compared to the initial treatment with dressings and antibiotics. Therefore prompt surgical intervention is important for treating FG induced by rectal cancer.

Keywords

References

  1. Campbell SC, Novick AC, Bukowski RM. Renal tumors. In: Wein AJ, Kavoussi LR, Novic AC, Partin AW, Peters CA, eds. Campbell-Walsh urology: ninth edition review. Saunders, 2007:1567-1637.
  2. Eskitascioglu T, Ozyazgan I, Coruh A, et al. Experience of 80 cases with Fournier's gangrene and "trauma" as a trigger factor in the etiopathogenesis. Ulus Travma Acil Cerrahi Derg 2014;20:265-274. https://doi.org/10.5505/tjtes.2014.67670
  3. Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg 2000;87:718-728. https://doi.org/10.1046/j.1365-2168.2000.01497.x
  4. Norton KS, Johnson LW, Perry T, Perry KH, Sehon JK, Zibari GB. Management of Fournier's gangrene: an eleven year retrospective analysis of early recognition, diagnosis, and treatment. Am Surg 2002;68:709-713. https://doi.org/10.1177/000313480206800810
  5. Clay LD 3rd, White JJ Jr, Davidson JT, Chandler JJ. Early recognition and successful management of pelvic cellulitis following hemorrhoidal banding. Dis Colon Rectum 1986;29:579-581. https://doi.org/10.1007/BF02554261
  6. Cunningham BL, Nivatvongs S, Shons AR. Fournier's syndrome following anorectal examination and mucosal biopsy. Dis Colon Rectum 1979;22:51-54. https://doi.org/10.1007/BF02586759
  7. Dewire DM, Bergstein JM. Carcinoma of the sigmoid colon: an unusual cause of Fournier's gangrene. J Urol 1992;147:711-712. https://doi.org/10.1016/s0022-5347(17)37363-9
  8. Sorensen MD, Krieger JN, Rivara FP, et al. Fournier's gangrene: population based epidemiology and outcomes. J Urol 2009;181:2120-2126. https://doi.org/10.1016/j.juro.2009.01.034
  9. Bruketa T, Majerovic M, Augustin G. Rectal cancer and Fournier's gangrene-current knowledge and therapeutic options. World J Gastroenterol 2015;21:9002-9020. https://doi.org/10.3748/wjg.v21.i30.9002
  10. Gupta N, Zinn KM, Bansal I, Weinstein R. Fournier's gangrene: ultrasound or computed tomography? Med Ultrason 2014;16:389-390.
  11. Paty R, Smith AD. Gangrene and Fournier's gangrene. Urol Clin North Am 1992;19:149-162. https://doi.org/10.1016/S0094-0143(21)00855-7
  12. National Comprehensive Cancer Network (NCCN). Palliative care (version. 2023). 2023. https://www.nccn.org/ professionals/physician_gls/pdf/palliative.pdf (accessed July 12, 2023)
  13. National Comprehensive Cancer Network (NCCN). Rectal cancer (version 4.2023). 2023. https://www.nccn.org/ professionals/physician_gls/pdf/rectal.pdf (accessed July 14, 2023)
  14. Heidary N, Naik H, Burgin S. Chemotherapeutic agents and the skin: an update. J Am Acad Dermatol 2008;58:545-570. https://doi.org/10.1016/j.jaad.2008.01.001
  15. Bernier J, Bonner J, Vermorken JB, et al. Consensus guidelines for the management of radiation dermatitis and coexisting acne-like rash in patients receiving radiotherapy plus EGFR inhibitors for the treatment of squamous cell carcinoma of the head and neck. Ann Oncol 2008;19:142-149. https://doi.org/10.1093/annonc/mdm400
  16. Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol 2005;16:1425-1433. https://doi.org/10.1093/annonc/mdi279
  17. Robert C, Soria JC, Spatz A, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol 2005;6:491-500. https://doi.org/10.1016/S1470-2045(05)70243-6
  18. Hu JC, Sadeghi P, Pinter-Brown LC, Yashar S, Chiu MW. Cutaneous side effects of epidermal growth factor receptor inhibitors: clinical presentation, pathogenesis, and management. J Am Acad Dermatol 2007;56:317-326. https://doi.org/10.1016/j.jaad.2006.09.005
  19. McCrea LE. Fulminating gangrene of the penis. Clinics 1945;4:796-829.