Non-Invasive Treatment of Extensive Eyelid Cancerous Lesion by Photodynamic Therapy: A Case Report

Abstract

Cancer of the eyelid represents approximately 10% of all skin cancer in the head and neck region, and approximately 5-10% of all skin cancers. Basal cell carcinoma is the most common cutaneous malignancy in the periocular area, accounting for approximately 70-90% of all cases. The standard treatment for eyelid cancer is surgical excision with reconstruction in case of orbital invasion. Such surgery is involved and in some cases can cause irreversible functional damage to the eye, as well as significant aesthetic and emotional distress for the patient. Photodynamic therapy is a wellestablished technique for the treatment of skin basal cell carcinoma. We therefore propose photodynamic therapy as an alternative treatment of non-melanoma skin cancer and are also indicated as principal option for same types of eyelid cancer. This is a case report of an eighty three year old patient with a histopathological diagnosis of basal cell carcinoma located in the left eyelid. The patient was treated by topical photodynamic therapy using a cream application of 20% Methyl-aminolevulic acid, and a fluency of 150 J/cm2. Clinical evaluation of the patient thirty days after treatment showed a significant clinical response with no evidence of scarring. In addition, no signs of recurrence were observed up to 6 months of follow-up. This clinical case thus showed excellent healing and cosmetic result. In summary, photodynamic therapy is a non-surgical treatment alternative that has the potential to become the number one option for eyelid cancer management, in particular for high risk patients or when surgical resection of highly involved areas is required.