Effectiveness of methyl-aminolevulinate-topical photodynamic therapy in the treatment of giant superficial basal cell carcinoma: presentation of two cases

Topical photodynamic therapy (PDT) with methyl-aminolevulinate (MAL) is used for non-surgical treatment of actinic keratoses (AK) and non-melanoma skin cancers (NMSCs). The authors report the results of a retrospective treatment of two giant Bcc in two patients. Both patients completed the MAL-PDT regimen and underwent post-treatment assessments over a follow-up period of five years. The risk of both initial treatment failure and recurrence was high but the dimension of lesions justified the therapeutic approach. Our results, even if obtained in two cases, indicate that MAL-PDT is a valid approach to patients with superficial and nodular basal cell carcinoma (BCC) with an acceptable tolerability profile and a very low risk of complications and avoid also poor cosmetic outcome, disfigurement, and recurrence. Finally, MAL-PDT is also preferable in area defined as “difficult to treat,” large lesions, in the H-zone, or in patients at high risk of surgical complications.