Treatment of grade III anal intraepithelial neoplasia with photodynamic therapy: report of a case.

Abstract

We report the use of photodynamic therapy to treat a 53-year-old female with Grade III anal intraepithelial neoplasia. Topical 5-aminolevulinic acid cream was applied to the affected area five hours before light treatment. The distribution of 5-aminolevulinic acid-induced protoporphyrin IX was identified by its characteristic red fluorescence. The lesion was treated by illumination with a 630-nm red laser light that used a total energy of 125 J/cm2 for approximately 17 minutes. Complete symptomatic relief was achieved after the first photodynamic therapy session, and macroscopic and microscopic ablation of dysplasia was achieved after a second session of photodynamic therapy. Healing was excellent, with no residual scarring or functional loss. Photodynamic therapy offers a simple, noninvasive method for treatment of anal intraepithelial neoplasia.