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Delayed septic radiation-induced calcinosis cutis long after cured anorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Calcinosis cutis is an anecdotal local injury seen long after irradiation in cancer survivors. Our purpose was to shed light on this little studied and potentially serious ulceration.

Cases

We report two cases of severe perineal-sacral infection with hard lesions, one decade after anorectal cancer irradiation. CT-scans showed extensive calcification and soft tissue inflammation, but previous radiation therapy was overlooked and the diagnosis was not made for several months after various tests, including biopsy. The two patients had different comorbidities and were managed by multidisciplinary collaboration between specialists. Surgery of the sacral ulcer was limited by the accessibility of non-irradiated tissues. In the absence of current guidelines, after radiopathological expertise, we used a “draining” procedure followed by antifibrotic pentoxifylline-tocopherol-clodronate treatment.

Conclusion

Long after pelvic radiotherapy, symptomatic subcutaneous macrocalcification is suggestive of radiation-induced calcinosis. Prolonged antibiotic therapy followed by PENTOCLO treatment led to clinical improvement.

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Authors and Affiliations

  1. Gastro-Enterologie - Proctologie, Hôpital Diaconesses - Croix Saint Simon, Paris, France

    Elsa Lambrescak

  2. Oncologie-Radiothérapie-Radiopathologie, Groupe Hospitalier Universitaire, APHP site Saint-Louis, Université de Paris, 1 ave Claude Vellefaux, 75010, Paris, France

    Sylvie Delanian

Authors
  1. Elsa Lambrescak
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  2. Sylvie Delanian
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Corresponding author

Correspondence to Sylvie Delanian.

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The two patients gave their written consent for publication of these cases.

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The authors declare that they have no conflict of interest.

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Lambrescak, E., Delanian, S. Delayed septic radiation-induced calcinosis cutis long after cured anorectal cancer. Int J Colorectal Dis 35, 333–336 (2020). https://doi.org/10.1007/s00384-019-03467-z

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  • DOI: https://doi.org/10.1007/s00384-019-03467-z

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