CO2 Laser Treatment of Multiple Oral Hamartomas in Cowden’s Syndrome: A Review and Case Study

Background Cowden’s syndrome is a genetic disorder characterized by multiple oral hamartomas and an increased risk of internal malignancy. These mucocutaneous lesions can be physically disfiguring and psychologically distressing. As a result, patients frequently seek treatment for their destruction. Removal of oral hamartomas is often a challenge due to their sensitive location and high risk of recurrence. Objective To review the clinical use, effectiveness, and safety of a fractional ablative laser to treat multiple oral hamartomas in a patient with Cowden’s syndrome. Materials and Methods A thorough literature review pertaining to treatment of oral hamartomas and a discussion of an illustrative case showcasing successful lesional destruction with a fractional ablative carbon dioxide (CO2) laser in a 33-year-old man with Cowden’s syndrome. Results Multiple oral hamartomas were effectively removed with fractional CO2 laser vaporization. No infection, scarring, dermatitis, nor lesional recurrence were observed 6 months post-treatment. Conclusion Fractional CO2 laser vaporization can be used effectively to treat multiple oral hamartomas associated with Cowden’s syndrome.

[1]  T. Alster,et al.  Dermatologic Laser Side Effects and Complications: Prevention and Management , 2020, American Journal of Clinical Dermatology.

[2]  P. Eşme,et al.  Oral hamartomatous lesion of Cowden's disease treated with the combination of erbium:YAG laser and topical sirolimus , 2019, Dermatologic therapy.

[3]  E. Moreira,et al.  Cowden syndrome: clinical case and a brief review. , 2017, Dermatology online journal.

[4]  Jeung-Hoon Lee,et al.  Treatment of multiple trichilemmomas with the pinhole method using a carbon dioxide laser in a patient with Cowden syndrome , 2015, Dermatologic Therapy.

[5]  T. Alster,et al.  Evolution of Laser Skin Resurfacing: From Scanning to Fractional Technology , 2014, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[6]  I. Coulson,et al.  Cowden syndrome (multiple hamartoma syndrome) , 2013, Clinical and experimental dermatology.

[7]  E. Swisher,et al.  Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. , 2013, Journal of the National Cancer Institute.

[8]  Prashanthi Chippagiri,et al.  Multiple Hamartoma Syndrome with Characteristic Oral and Cutaneous Manifestations , 2013, Case reports in dentistry.

[9]  M. Landthaler,et al.  Laser thermal therapy of benign skin tumours: Review and update , 2011, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[10]  V. Sutton,et al.  Oral rapamycin in the treatment of patients with hamartoma syndromes and PTEN mutation , 2011, Pediatric blood & cancer.

[11]  T. Alster,et al.  Fractionated Laser Skin Resurfacing Treatment Complications: A Review , 2010, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[12]  R. Geronemus,et al.  Ablative and fractional ablative lasers. , 2009, Dermatologic clinics.

[13]  T. Alster Cutaneous resurfacing with CO2 and erbium: YAG lasers: preoperative, intraoperative, and postoperative considerations. , 1999, Plastic and reconstructive surgery.

[14]  R. Wheeland,et al.  Cowden's disease--treatment of cutaneous lesions using carbon dioxide laser vaporization: a comparison of conventional and superpulsed techniques. , 1989, The Journal of dermatologic surgery and oncology.

[15]  B. Pecaro,et al.  The CO2 laser in oral and maxillofacial surgery. , 1983, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  C. Eng,et al.  Cowden syndrome: Recognizing and managing a not‐so‐rare hereditary cancer syndrome , 2015, Journal of surgical oncology.