Photodynamic therapy for extensive oral verrucous/granular leukoplakia with moderate-to-severe dysplasia: A case study

Non-homogeneous oral verrucous/granular leukoplakia is a potentially malignant disorder with a higher malignant transformation rate than homogeneous leukoplakia. Surgical resection is commonly performed since the disease is often malignant and refractory. However, surgical intervention is painful and heavily impairs the patients' quality of life. Photodynamic therapy is minimally invasive, can be administered repeatedly, and is widely used to treat potentially malignant disorders and cancers. We report a case of oral verrucous/granular leukoplakia with extensive lesions in a 58-year-old man. Histopathological examination showed moderate-to-severe dysplasia and a tendency of malignant transformation in the focal area. At this stage, the patient was recommended for surgery by the oncology department. With the patient's consent, photodynamic therapy was performed at our department while he awaited the surgery. In the absence of any auxiliary measures, eight treatments with 5-aminolevulinic acid-mediated photodynamic therapy achieved favorable results, and there no recurrence was observed after 7 months of follow-up. This result suggests that photodynamic therapy should be considered when treating potentially malignant disorders such as oral verrucous/granular leukoplakia, or as pre-treatment before surgical resection.