Abstract: Surgical resection is the first-line treatment for vulvar cutaneous malignant tumors, but it is associated with several challenges: difficult-to-suture soft tissue defects due to complex vulvar anatomy, increased risk of tumor residue when reducing surgical margins to close the wound, and poor tolerance to prolonged surgery in some elderly patients. Photodynamic therapy (PDT) can serve as an effective postoperative adjuvant modality to eliminate potential residual lesions. This article reports 3 cases of vulvar malignant tumors treated with surgery combined with PDT.All 3 patients were pathologically confirmed without metastasis and had no significant medical history. After surgical resection, they received topical 5-aminolevulinic acid (ALA)-based PDT for 3 sessions. Three patients were followed up for 2 years, 1year, and 6 months, respectively with no reccurrence. None of the patients had residual significant functional impairment or cosmetic defects.This study confirms that surgery combined with topical ALA-PDT is an effective therapeutic regimen for vulvar cutaneous malignant tumors.

Key words: photodynamic, aminoketoglutaric acid, surgery, vulvar malignancy, Bowen's disease, extramammary Paget's disease