Photodynamic therapy for long-term management of oral leukoplakia: A 10-year follow-up case report

Abstract

Oral leukoplakia (OLK) is a prevalent oral potentially malignant disorder. Long-term management of OLK poses significant clinical challenges due to its high recurrence rate and substantial risk of malignant transformation. Conventional therapies include topical and systemic pharmacotherapy, surgical treatment, and laser therapy. However, photodynamic therapy (PDT) offers distinct advantages such as minimal invasiveness, mild adverse effects, repeatability, and no negative impact on aesthetics or function. To date, the application of PDT in the long-term management of OLK has been rarely reported in the literature. In this case, a non-smoking female exhibited non-homogeneous leukoplakia located in the high-risk area of the ventral tongue, conferring substantial malignant transformation potential. A disease course timeline illustrates over 10 years of management encompassing 109 clinical encounters. The patient had poor response to pharmacological treatments and experienced postoperative recurrence after surgical intervention. However, after the introduction of PDT, the condition was effectively controlled. Analysis of the 25 PDT sessions administered to date revealed an efficacy rate of 92% for complete or partial regression. We have also summarized the methods and principles for the long-term management of OLK with PDT. Over more than 10 years of follow-up, this case has not developed malignant transformation, and the condition remains stable, highlighting the significant clinical value of PDT in the management of OLK.