To overcome this limitation, a wide range of adjunct non-procedure treatments have been tried, including subjecting the tumor to intralesional sclerosant, either with corticosteroids, PDE-5 inhibitors such as systemic sildenafil, or mTOR inhibitors like sirolimus, as well as carbon dioxide laser ablation of the cysts and pre-operative embolization. This evidence concerns the gene PDE5A and neoplasm.