Surgery sequential with 5-Aminolevulinic acid photodynamic therapy for lip squamous cell carcinoma: Two cases reports

Squamous cell carcinoma (SCC) of thelip is conventionally treated by extended surgery or radiotherapy, which may cause deformities and dysfunction due to this special location. Topical 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) for SCC in situ is effective and non-invasive, and may preserve normal morphological structure. However, the effectiveness is limited by tumor size and depth due to the permeability of photosensitizer and penetration depth of the therapeutic light source. We successfully treated two cases of lip invasive SCC (tumor size is 22.4 mm × 16.1 mm × 11.9 mm and 23 mm × 15 mm × 5 mm) with superficial resection surgery to reduce tumor load and sequential ALA-PDT (20 % ALA, 3 h incubation, 200 J/cm²) to remove residual tumor. During the treatment, ultrasonography was used to monitor the tumor invasion depth and assess the therapeutic efficacy. Both cases showed tumor free at 12 months of follow-up. These two cases suggest that ALA-PDT combined with minimal invasive surgery is a viable treatment for special cases of lip SCC.