Treatment of Verrucous Carcinoma with Imiquimod and CO2 Laser Ablation

• Published in: Dermatology (Basel) Vol. 207; no. 1; pp. 119 - 122
• Main Authors: Heinzerling, L.M., Kempf, W., Kamarashev, J., Hafner, J., Nestle, F.O.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Basel, Switzerland Karger 01.01.2003; S. Karger AG
• Subjects: Aged; Aged, 80 and over; Aminoquinolines - administration & dosage; Biological and medical sciences; Biopsy, Needle; Carbon Dioxide; Carcinoma, Verrucous - pathology; Carcinoma, Verrucous - therapy; Combined Modality Therapy; Dermatology; Female; Follow-Up Studies; Human papillomavirus 6b; Humans; Immunohistochemistry; Laser Therapy; Medical sciences; Neoplasm Staging; Pharmacology. Drug treatments; Risk Assessment; Skin Neoplasms - pathology; Skin Neoplasms - therapy; Skin, nail, hair, dermoskeleton; Treatment Outcome; Tumors of the skin and soft tissue. Premalignant lesions; Buschke-Löwenstein tumor; Human papilloma virus; CO2 laser; Verrucous carcinoma; Topical treatment; Imiquimod; Human; Giant condyloma acuminatum of Buschke Lowenstein; Verrucous squamous cell carcinoma; Malignant tumor; CO; Ablation; Genital diseases; Percutaneous route; Infection; Case study; Local administration; Chemotherapy; laser; Viral disease; Combined treatment; Benign neoplasm; Elderly
• ISSN: 1018-8665; 1421-9832
• DOI: 10.1159/000070963

An 82-year-old female patient presented with a large perianal hyperkeratotic tumor extending into the anal canal. Staging did not reveal any metastatic spread. Diagnosis of verrucous carcinoma or Buschke-Löwenstein tumor, respectively, was based on typical clinical and histologic features. Moreover, human papillomavirus 6b DNA sequences could be detected by PCR. Surgical excision could not be performed due to the general health status of the patient; thus, alternative therapy methods were necessary. Treatment with imiquimod cream 5% (Aldara ® ), a topical immune response modifier applied once a day and left for 12 h, led to significant partial tumor regression and clear demarcation of the tumor. The remaining tumor, now feasible for treatment with CO 2 laser, was removed in two sessions in local anesthesia. In a third session, tumor parts in the anal canal were vaporized. This case demonstrates that the combination of imiquimod and CO 2 laser ablation is an effective treatment option for verrucous carcinoma.