Department of Dermatology, Wertheim College of Medicine, Florida International University, Miami, FL, USA.
J Dermatolog Treat. 2020 Mar;31(2):180-182. doi: 10.1080/09546634.2019.1589642. Epub 2019 Mar 7.
The current gold standard and the first line of treatment for non-melanoma skin cancer is surgical excision. Nevertheless, some patients are not good candidates for surgery when wound healing may be impaired. A 96-year-old male presented with 1.2 cm by 1.5 cm tumoral lesion with an ill-infiltrated border and central ulceration located on the mid right lower leg. Biopsy confirmed the diagnosis of squamous cell carcinoma (SCC) . The primary lesion was treated centrally to peripherally with multiple intralesional injections of 1.5 mL 5-Fluorouracil (5-FU) (50 mg/mL). The lesion was also treated with a single layer application of 80% Trichloroacetic acid (topical solution). One additional and final treatment of only 80% TCA was performed after three weeks. There was a complete regression of the SCC three weeks after the second treatment. We demonstrate a case of SCC successfully treated with intralesional 5-FU and topical Trichloroacetic acid. Additionally, the SCC was successfully cleared in two treatment sessions with the lowest cumulative dose of 5-FU reported. Intralesional injections of 5-FU and subsequent topical Trichloroacetic acid may be an effective option for patients with SCC who are not eligible for cutaneous surgery.
目前，非黑色素瘤皮肤癌的金标准和一线治疗方法是手术切除。然而，当伤口愈合可能受损时，有些患者不适合手术。一名 96 岁男性，右小腿中下段有一个 1.2cm×1.5cm 的肿瘤性病变，边界浸润不良，中央溃疡。活检证实诊断为鳞状细胞癌（SCC）。中心至周边对原发性病变进行多次瘤内注射 1.5mL 5-氟尿嘧啶（5-FU）（50mg/mL）。病变也用 80%三氯乙酸（外用溶液）单层涂抹。三周后，仅进行了最后一次 80%TCA 治疗。第二次治疗后三周，SCC 完全消退。我们成功地使用瘤内注射 5-FU 和外用三氯乙酸治疗了一例 SCC。此外，在两次治疗中，SCC 均成功清除，报告的 5-FU 累积剂量最低。对于不适合皮肤手术的 SCC 患者，瘤内注射 5-FU 随后外用三氯乙酸可能是一种有效的选择。
