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Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy.
Surg Case Rep. 2018 Sep 26; 4(1):123.SC

Abstract

BACKGROUND

Fournier's gangrene is a necrotizing fasciitis of the genital and perineal region. It may progress, affecting the groin, the thigh, or even the abdominal wall. Despite adequate treatment (debridement and antibiotics), the mortality rate is very high, reaching 20-35%. Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy is very rare. We report this case with a review of the literature.

CASE PRESENTATION

A 68-year-old man visited the emergency room due to perineal pain during which he accepted the chemotherapy for locally advanced rectal cancer. Abdominal CT scan showed extensive emphysema in the scrotum and gluteus maximus muscle. We diagnosed as Fournier's gangrene caused by penetration of a rectal cancer. We performed debridement, left orchiectomy, transverse colostomy with double orifices. Post-operative day 30, we performed abdominoperineal resection. We performed CapeOX therapy eight courses as adjuvant chemotherapy. The patient had no recurrence for 1 year and 2 months after the operation.

CONCLUSIONS

Going forward, knowledge gained from this case will increase the opportunity to perform neoadjuvant chemotherapy for locally advanced rectal cancer. In medical treatment, we must put the possibility of Fournier's gangrene in mind and treat as soon as possible.

Links

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Authors+Show Affiliations

Kobayashi D
Department of Surgery, Komaki City Hospital, 1-20 Joubushi, Komaki, Aichi, 485-8520, Japan. mmmeerryyyy2101@yahoo.co.jp.
Masubuchi M
Department of Surgery, Kainan Hospital, 396 Minamihonden, Maegasu-cho, Yatomi, Aichi, 498-8502, Japan.
Takase T
Department of Surgery, Kainan Hospital, 396 Minamihonden, Maegasu-cho, Yatomi, Aichi, 498-8502, Japan.
Ichikawa T
Department of Surgery, Kainan Hospital, 396 Minamihonden, Maegasu-cho, Yatomi, Aichi, 498-8502, Japan.
Deguchi T
Department of Surgery, Kainan Hospital, 396 Minamihonden, Maegasu-cho, Yatomi, Aichi, 498-8502, Japan.
Yaguchi T
Department of Surgery, Kainan Hospital, 396 Minamihonden, Maegasu-cho, Yatomi, Aichi, 498-8502, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30259251

Citation

Kobayashi, Daigo, et al. "Fournier's Gangrene Caused By Penetration of a Rectal Cancer Followed By Neoadjuvant Chemotherapy." Surgical Case Reports, vol. 4, no. 1, 2018, p. 123.
Kobayashi D, Masubuchi M, Takase T, et al. Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy. Surg Case Rep. 2018;4(1):123.
Kobayashi, D., Masubuchi, M., Takase, T., Ichikawa, T., Deguchi, T., & Yaguchi, T. (2018). Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy. Surgical Case Reports, 4(1), 123. https://doi.org/10.1186/s40792-018-0526-0
Kobayashi D, et al. Fournier's Gangrene Caused By Penetration of a Rectal Cancer Followed By Neoadjuvant Chemotherapy. Surg Case Rep. 2018 Sep 26;4(1):123. PubMed PMID: 30259251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy. AU - Kobayashi,Daigo, AU - Masubuchi,Mariko, AU - Takase,Tsunenobu, AU - Ichikawa,Takahiro, AU - Deguchi,Tomohiro, AU - Yaguchi,Toyohisa, Y1 - 2018/09/26/ PY - 2018/05/15/received PY - 2018/09/10/accepted PY - 2018/9/28/entrez PY - 2018/9/28/pubmed PY - 2018/9/28/medline KW - Fournier’s gangrene KW - Locally advanced rectal cancer KW - Neoadjuvant chemotherapy SP - 123 EP - 123 JF - Surgical case reports JO - Surg Case Rep VL - 4 IS - 1 N2 - BACKGROUND: Fournier's gangrene is a necrotizing fasciitis of the genital and perineal region. It may progress, affecting the groin, the thigh, or even the abdominal wall. Despite adequate treatment (debridement and antibiotics), the mortality rate is very high, reaching 20-35%. Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy is very rare. We report this case with a review of the literature. CASE PRESENTATION: A 68-year-old man visited the emergency room due to perineal pain during which he accepted the chemotherapy for locally advanced rectal cancer. Abdominal CT scan showed extensive emphysema in the scrotum and gluteus maximus muscle. We diagnosed as Fournier's gangrene caused by penetration of a rectal cancer. We performed debridement, left orchiectomy, transverse colostomy with double orifices. Post-operative day 30, we performed abdominoperineal resection. We performed CapeOX therapy eight courses as adjuvant chemotherapy. The patient had no recurrence for 1 year and 2 months after the operation. CONCLUSIONS: Going forward, knowledge gained from this case will increase the opportunity to perform neoadjuvant chemotherapy for locally advanced rectal cancer. In medical treatment, we must put the possibility of Fournier's gangrene in mind and treat as soon as possible. SN - 2198-7793 UR - https://www.unboundmedicine.com/medline/citation/30259251/Fournier's_gangrene_caused_by_penetration_of_a_rectal_cancer_followed_by_neoadjuvant_chemotherapy_ DB - PRIME DP - Unbound Medicine ER -