Fournier's gangrene secondary to locally advanced prostate cancer: case report and review of the Literature

G Chir. 2019 Nov-Dec;40(6):481-496.

Abstract

Fournier's gangrene is a rare and potentially lethal condition. Previously described as an idiopathic process, this necrotising fasciitis is secondary to infection and in 95% of cases the cause arises from ano-rectum (30-50%), uro-genitalia (20-40%) or genital skin (20%). Cancer could lead to a Fournier's gangrene thanks a Romacompromised host immunity condition. In the past the rate of death was high ranging from 20% to 80%, while currently mortality is decreasing to 10%. We report a case of a 76-years-old man with Fournier's Gangrene due to locally advanced prostate cancer. The multimodal therapeutic management included broad-spectrum antibiotic therapy, intravenous fluid resuscitation and surgical debridement that was delayed by the will of the patient. To our knowledge, this is the first case of Fournier's gangrene caused by prostate cancer without common predisposing factors. In order to improve the knowledge about this rare disease, we performed a narrative review of the literature.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / etiology
  • Bacterial Infections / surgery
  • Coinfection
  • Combined Modality Therapy
  • Debridement
  • Fournier Gangrene / etiology*
  • Fournier Gangrene / surgery
  • Fournier Gangrene / therapy
  • Humans
  • Hyperbaric Oxygenation
  • Male
  • Neoplasm Invasiveness
  • Orchiectomy
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / pathology

Substances

  • Anti-Bacterial Agents