F Andrew Morfesis, MD. Highsmith Hospital
Index patient is a 48 year old HIV positive homosexual man with anal-scrotal condylomas (AIN) initially resected in 2012, then treated with radiation in 2014 for recurrence. Recurred in 2016 with changes severe enough to "…consider diagnosis of invasive squamous cell carcinoma…". Patient elected trial of Imiquimod 5% cream three times per week to defer recommendation of abdomino-perineal resection. Imiquimod has no antiviral effect but stimulates interferon and cytokines to suppress HPV subtypes 6 and 11, among other immune effects. No data exists as to systemic effects of Imiquimod. After three months of therapy, lesions had largely regressed with only one specimen showing "…concern for squamous cell carcinoma in situ…". Patient has elected to continue treatment pending further biopsy. This report is typical of a number of other reports of small numbers of cases of neoplasia regression with Imiquimod 5% cream to include Melanoma-in-situ, Basal cell cancer of skin and other cutaneous malignancies as well as VIN. A second female patient, 38 years old, HIV+ with HPV lesions (AIN3) including urethral lesions, is being treated with vulvar application of Imiquimod to determine if urethral lesions will regress. There is no FDA-approved indication for mucosal application of Imiquimod. Biopsies are pending at completion of six month trial of Imiquiimod.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84722
Program Number: P371
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster