High-risk HPV clearance and CIN 3 treated with MAL-PDT: A case report

• Published in: Photodiagnosis and photodynamic therapy Vol. 31; p. 101937
• Main Authors: de Castro, Cynthia Aparecida, Lombardi, Welington, Stringasci, Mirian Denise, Bagnato, Vanderlei Salvador, Inada, Natalia Mayumi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2020
• Subjects: Adult; Aminolevulinic Acid - therapeutic use; Cervical intraepithelial neoplasia; Cervical Intraepithelial Neoplasia - drug therapy; Female; High-risk HPV; Humans; MAL-PDT; Neoplasm Recurrence, Local - drug therapy; Papillomavirus Infections - drug therapy; Photochemotherapy; Photochemotherapy - methods; Photodynamic therapy; Photosensitizing Agents - therapeutic use; Uterine Cervical Neoplasms - drug therapy; Photodynamic therapy; MAL-PDT; High-risk HPV; Photochemotherapy; Cervical intraepithelial neoplasia
• ISSN: 1572-1000; 1873-1597
• DOI: 10.1016/j.pdpdt.2020.101937

•CIN 3 and high-risk HPV virus were eliminated 120 days after two PDT procedures.•Colposcopy, cytology, and PCR-HPV RNA were negative on the 6 months follow-up.•Topical MAL-PDT illuminating ecto and endocervix simultaneously could be a promising strategy to treat high-grade CIN. High-grade cervical intraepithelial neoplasia (CIN) is the precursor to cervical cancer. HPV (human papillomavirus) infection is strongly related with this disease. The CIN treatment is generally excision of the transformation zone (ETZ). Photodynamic therapy (PDT) has also shown to be a promising treatment. We are reporting a case of a 33-years-old patient with high-grade CIN 3 treated with topical MAL (methyl aminolevulinate) PDT. Was applied 2.5 g of 20 % (w/w) MAL cream overnight and the cervix was illuminated twice, with three weeks apart, using a probe with LEDs simultaneously with a cylindrical laser fiber emitting both at 630 nm, with a fluency of 150 J/cm2. CIN 3 and the presence of high-risk HPV virus was eliminated 120 days after the second procedure. There was no recurrence at 6 months follow-up. This case report using MAL-PDT and a different light arrangement with LEDs and laser fiber associated both cured the patient with CIN 3 and eliminated low and high-risk HPV in just two PDT sessions.