Treatment of Grade III Anal Intraepithelial Neoplasia With Photodynamic Therapy

PURPOSE: We report the use of photodynamic therapy to treat a 53-year-old female with Grade III anal intraepithelial neoplasia. METHODS: 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. RESULTS: 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. CONCLUSION: Photodynamic therapy offers a simple, noninvasive method for treatment of anal intraepithelial neoplasia.