Clearance of a thick invasive squamous cell carcinoma after multiple treatments with topical photodynamic therapy.
OBJECTIVE
Tumor depth is the limiting factor for topical photodynamic therapy (PDT) treating cutaneous invasive squamous cell carcinoma (SCC). The thickness of  < 2-3 mm below the epidermis is the currently recommended effective response depth in nonmelanoma skin cancers. We report an unusual outgrowing SCC with a tumor depth of 5.5 mm, which was successfully treated with PDT.


METHODS
Topical 20% (wt/wt) 5-aminolaevulinic acid emulsion was applied for 6 h before irradiation with 633-nm red light. The lesion was irradiated 7 times, 1 week apart, at a total dose of 791 J/cm(2).


RESULTS
Twelve months later, histologic and clinical examination showed a complete remission and no local or systemic metastases. No serious side effects occurred, and the cosmetic outcome was excellent.


CONCLUSIONS
PDT may offer a noninvasive, well-tolerated, and effective therapy for inoperable low-risk SCC with an outgrowing pattern. It suggests that tumor depth is not an absolute predictor, but only a suggested reference.
Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China. qiangli@fmmu.edu.cn
Qiang
Q
Li
Tianwen
T
Gao
Heather Ann
HA
Long
Hideyuki
H
Ujiie
D000287:Administration, Topical; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D012074:Remission Induction; D018570:Risk Assessment; D012535:Scalp; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid