Penile Intraepithelial Neoplasia: Results of Photodynamic Therapy

Abstract

Failure of response to treatment or recurrent disease is often noted in patients with penile intraepithelial neoplasia. Photodynamic therapy has recently been added to the list of treatment modalities used for this diagnosis. Our primary objective was to study the results of photodynamic therapy in the treatment of penile intraepithelial neoplasia in men over the age of 40 years. Ten patients aged 42-82 years with histopathologically confirmed lesions were studied. Lesions initially responded to photo-dynamic therapy in 7 out of 10 patients. Four of these patients presented no recurrences during a mean follow-up of 35 months, and were completely cleared after 2-8 treatments (mean 4.5 treatments). Three patients presented recurrences after treatment. No patient developed invasive penile cancer (mean follow-up 46.5 months). Photodynamic therapy is an alternative in the treatment of penile intraepithelial neoplasia, although prospective randomized trials are required to provide therapeutic guidelines.

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

“…There was sustained clearance in the remaining patients over 46 months, including clearance of human HPV DNA. 162 In difficult cases, Mohs micrographic surgery has been used to include tissue taken from the distal urethra and the defect covered by a flap repaired from the external part of the prepuce. Total glans surgical resurfacing was reported to be effective in a series of 10 patients, with good cosmesis.…”

Penile Squamous Cell Carcinoma Diagnosed following Treatment of Urethrocutaneous Fistula after CO2Laser Therapy for Misdiagnosed Penile Lesion: Report of a Case

“…The treatments of penile carcinoma were phodynamic therapy, 5-Fluorouracil cream, cryosurgery with liquid nitrogen and Nd-YAG laser therapy. [5][6][7][8] Laser treatment of T1 and T2 stage carcinoma penis has several advantages. During or post laser, there is no blood loss, pain relief is achieved with oral analgesics, there is no wound infection, and antibiotic administration is not required.…”

Erythroplasia of Queyrat

“…In a study with methyl aminolevulinate PDT for carcinoma in situ of the penis, excellent cosmetic results have been reported, but three out of ten patients had histopathologically residual disease (Axcrona et al 2007 ). Also, Paoli et al ( 2006 ) found initially a response to photodynamic therapy in seven out of ten patients treated with delta-5-aminolevulinic acid or methyl aminolevulinate PDT. Four of these patients presented no recurrences during a mean follow-up of 35 months and were completely cleared after two to eight treatments (mean 4.5 treatments).…”