To report a case of successful treatment of residual extramammary Paget's disease (EMPD) using intralesional aminolevulinic acid photodynamic therapy (ALA-PDT).
Approach:
Patient Background: An elderly male with scrotal EMPD underwent surgical excision, which revealed positive margins and tumor infiltration into subcutaneous fat.
Treatment Method: Intralesional 5-aminolevulinic acid (ALA) was injected monthly into the residual plaque, followed by light irradiation.
Monitoring and Results: The treatment involved three sessions, leading to marked thinning and fading of the plaque, with complete regression after six sessions.
Key Findings:
Intralesional ALA-PDT achieved complete clinical regression of residual EMPD.
The treatment was well-tolerated with mild pain and transient erythema.
No recurrence was observed during the 6-month follow-up period.
Interpretation:
Intralesional ALA-PDT is effective for treating EMPD with deep dermal invasion.
Limitations:
The study is based on a single case report, limiting generalizability.
Long-term efficacy and safety beyond 6 months remain to be established.
Conclusion:
Intralesional ALA-PDT represents a minimally invasive option for residual EMPD.
An updated clinical practice guideline from the American Society for Radiation Oncology substantially expands and modernizes recommendations for the use of radiation therapy in pancreatic cancer.
