Although the treatment of choice for GCBL is surgical excision, various chemotherapeutic modalities have been used with mixed success as adjuvants to surgery or as treatment for recurrences. The postulated viral origin of these tumors led to the use of interferon with moderate success. One case of vaginal GCBL responded to 6 months of interferon-2 alpha with apparent complete resolution. Traditional systemic antitumor agents also have been used. Autopsy 1 year later showed no evidence of active disease.
Radiation therapy remains a controversial subject.
While some studies show evidence of new aggressive behavior after radiation, more than a few case reports document resolution of small tumors after radiation. As a drawback, it typically requires at least a partial penectomy. From this viewpoint, it would appear that Mohs surgery would be the most efficacious, allowing specimen examination and sparing most of the tissue. One case report noted that intralesional bleomycin in the wound bed of an incompletely resected tumor was effective with no recurrence at 2 years. Resection with CO 2 laser also has been effective, with the advantage of permitting a bloodless field.