Photodynamic therapy with hematoporphyrin derivative for the treatment of penile verrucous carcinoma: A case report

Verrucous carcinoma, a well-differentiated variant of squamous cell carcinoma with low-grade malignancy, is often associated with localized human papillomavirus (HPV) infection and excessive penile foreskin. We report a 45-year-old male who presented with a verrucous plaque on the glans penis for over four months, along with itching. Examination revealed a verrucous, erosive lesion with a cauliflower-like surface, firm texture, and irregular shape, accompanied by pain, bleeding, and a foul odor. Syphilis and HIV tests were negative, and a biopsy confirmed verrucous carcinoma.The patient underwent initial circumcision at a local hospital, but persistent lesions raised concerns about further surgery impairing sexual function and anatomical integrity. To preserve both anatomical and functional integrity, the patient opted for Hematoporphyrin DerivativePhotodynamic Therapy (HpD-PDT). Post-treatment, the lesions regressed, and after four years of follow-up, there was no scarring or recurrence. The clinical outcome was favorable with complete lesion regression.We propose that PDT is a viable treatment option for penile verrucous carcinoma, offering advantages over traditional methods in terms of function preservation and cosmetic outcomes.