Skip to main content
Log in

Photodynamic therapy for residual neoplasms of the perianal skin

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: The aim of this study was to evaluate the efficacy of photodynamic therapy in the management of residual neoplasms of the perianal skin. METHODS: This is a retro-spective review. Five patients with pathologic confirmation of residual perianal neoplasms were treated with photodynamic therapy. There were three females. The mean age was 52 (range, 33–79) years. Pathology consisted of Bowen's disease in two patients, squamous-cell carcinoma in two patients, and extramammary Paget's disease in one patient. Four patients received one photodynamic therapy treatment and one patient received two treatments three months apart. RESULTS: Treatment was followed by immediate perianal erythema, subsequent blister formation in 36 to 48 hours, and sloughing of the treated area in 72 hours. With a mean follow-up of 5.2 (range, 1–8) years, there were two recurrences. One recurrence was in a patient four years after treatment for Paget's disease, and the other was in a patient nine months after treatment for Bowen's disease. The latter was managed successfully with wide local excision. Treatment-related toxicities included significant perianal pain in four patients, controlled with analgesia management. CONCLUSIONS: Photodynamic therapy can successfully be used after wide local excision for residual neoplasms of the perianal skin. Treatment can be rendered with acceptable morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Shutze WP, Gleysteen JJ. Perianal Paget's disease. Classification and review of management: report of two cases. Dis Colon Rectum 1990;33:502–7.

    Article  PubMed  Google Scholar 

  2. Greenall MJ, Quan SH, Stearns MW, Urmacher C, De-Cosse J. Epidermoid cancer of the anal margin: pathologic features, treatment and clinical results. Am J Surg 1985;149:95–101.

    PubMed  Google Scholar 

  3. Beck DE, Fazio VW, Jagelman DG, Lavery IC. Perianal Bowen's disease. Dis Colon Rectum 1988;31:419–22.

    PubMed  Google Scholar 

  4. Lee MM, Wick MM. Bowen's Disease. CA Cancer J Clin. 1990;40:237–42.

    PubMed  Google Scholar 

  5. Berardi RS, Lee S, Chen HP. Perianal extramammary Paget's disease. Surg Gynecol Obstet 1988;167:359–66.

    PubMed  Google Scholar 

  6. Thirlby RC, Hammer C Jr, Galagan KA, Travaglini JJ, Picozzi VJ Jr. Perianal Paget's disease. Successful treatment with combined chemoradiotherapy: report of a case. Dis Colon Rectum 1990;33:150–2.

    Article  PubMed  Google Scholar 

  7. Matsumoto K, Kitagawa T, Terashima H. Pelvic exenteration for perianal Paget's disease. J Clin Gastroenterol 1988;10:591–2.

    PubMed  Google Scholar 

  8. Dougherty TJ. Photosensitizers: therapy and detection of malignant tumors. Photchem Photobiol 1987;45:879–89.

    Google Scholar 

  9. Wilson BD, Mang TS, Cooper M, Stoll H. Use of photodynamic therapy for treatment of extensive basal cell carcinomas. Facial Plast Surg 1989;6:185–9.

    PubMed  Google Scholar 

  10. Petrelli NJ, Cebollero JA, Rodriguez-Bigas M, Mang T. Photodynamic therapy in the management of neoplasms of the perianal skin. Arch Surg 1992;127:1436–8.

    PubMed  Google Scholar 

  11. Moller R, Reymann F, Hou-Jensen K. Metastases in dermatological patients with squamous cell carcinoma. Arch Dermatol 1979;115:703–5.

    Article  PubMed  Google Scholar 

  12. Cummings BJ. Anal Cancer. Int J Radiat Oncol Biol Phys 1990;19:1309–15.

    PubMed  Google Scholar 

  13. Kao GF. Carcinoma arising in Bowen's disease. Arch Dermatol 1986;122:1124–6.

    Article  PubMed  Google Scholar 

  14. Harrison EG Jr, Beahrs OH, Hill JR. Anal and perianal malignant neoplasms: pathology and treatment. Dis Colon Rectum 1966;9:255–67.

    PubMed  Google Scholar 

  15. Graham JH, Helwig EB. Bowen's disease and its relationship to systemic cancer. Arch Dermatol 1959;80:133–59.

    Google Scholar 

  16. Graham JH, Helwig EB. Bowen's disease and its relationship to systemic cancer. Arch Dermatol 1961;83:738–58.

    PubMed  Google Scholar 

  17. Arbesman H, Ransohoff DF. Is Bowen's disease a predictor for the development of internal malignancy? A methodological critique of the literature. JAMA 1987;257:516–8.

    Article  PubMed  Google Scholar 

  18. Cleary RK, Schaldenbrand JD, Fowler JJ, Schuler JM, Lampman RM. Perianal Bowen's disease and anal intraepithelial neoplasia: review of the literature. Dis Colon Rectum 1999;42:945–51.

    Article  PubMed  Google Scholar 

  19. Marchesa P, Fazio VW, Oliart S, Goldblum JR, Lavery IC. Perianal Bowen's disease: a clinicopathologic study of 47 patients. Dis Colon Rectum 1997;40:1286–93.

    Article  PubMed  Google Scholar 

  20. Helwig EB, Graham JH. Anogenital (extramammary) Paget's disease. Cancer 1963;16:387–403.

    PubMed  Google Scholar 

  21. Sarmiento JM, Wolff BG, Burgart LJ, Frizelle FA, Ilstrup DM. Paget's disease of the perianal region—an aggressive disease? Dis Colon Rectum 1997;40:1187–94.

    Article  PubMed  Google Scholar 

  22. Bugelsk PJ, Potter CW, Dougherty TJ. Autoradiographic distribution of hematoporphyrin derivative in normal and tumor tissue of the mouse. Cancer Res 1981;41:4606–12.

    PubMed  Google Scholar 

  23. Dougherty TJ, Gomer CJ, Henderson BW,et al. Photodynamic therapy. J Natl Cancer Inst 1998;90:889–905.

    Article  PubMed  Google Scholar 

  24. Weishaupt KR, Gomer CJ, Dougherty TJ. Identification of singlet oxygen as the cytotoxic agent in photoactivation of a murine tumor. Cancer Res 1976;36:2326–9.

    PubMed  Google Scholar 

  25. Manyak MJ, Russo A, Smith PD, Glatstein E. Photodynamic therapy. J Clin Oncol 1988;6:380–91.

    PubMed  Google Scholar 

  26. Pennington DG, Waner M, Knox A. Photodynamic therapy for multiple skin cancers. Plast Reconstr Surg 1988;114:175–8.

    Google Scholar 

  27. Wilson BD, Mang TS, Stoll H, Jones C, Cooper M, Dougherty TJ. Photodynamic therapy for the treatment of basal cell carcinoma. Arch Dermatol 1992;128:1597–601.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Runfola, M.A., Weber, T.K., Rodriguez-Bigas, M.A. et al. Photodynamic therapy for residual neoplasms of the perianal skin. Dis Colon Rectum 43, 499–502 (2000). https://doi.org/10.1007/BF02237193

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02237193

Key words

Navigation