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Development of malignancy in pilonidal sinus is a rare complication. The disease occurs most frequently in men. About 69 cases have been reported so far in literature. The lesion is mostly a well-differentiated squamous cell carcinoma. Best treatment is local wide excisions along with a short period of local wound care. After healthy granulation tissue, definitive closure of the defect is done with rotational flaps or skin grafts. Fine needle aspiration cytology is mandatory for palpable inguinal nodes. The prognosis is very poor if inguinal node has metastatic deposits. Radiation therapy may be used as palliative therapy for local bone or soft tissue recurrences. Recently, both topical and systemic chemotherapy have been used without promising results.
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