Kaposi Sarcoma Associated With Systemic Corticosteroid Therapy (original) (raw)
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Kaposi's sarcoma following long term steroid therapy
The Malaysian journal of pathology
An 18-year-old Malay lady was treated with high dose steroids for three and a half years for idiopathic thrombocytopaenic purpura. At 21 years, after a series of relapses, a splenectomy was carried out. In addition, two nodules at the hilum of the spleen were also removed. Histological examination of these nodules revealed features of Kaposi's sarcoma. Kaposi's sarcoma resulting from immunosuppression by corticosteroids is rare. Our patient is the first such case reported in Malaysia.
Open Journal of Internal Medicine, 2015
Corticosteroid therapy has revolutionized the treatment of many diseases in medicine. The most concerned diseases are chronic inflammatory diseases. Its use may be either short-term or long-term, thus generating several side effects, some of which are conventional and known, but others are rare, such as Kaposi's sarcoma. We report here a particular clinical observation. Observation: This is a patient of 37 years, who consults in Internal Medicine for the treatment of mucocutaneous lesions, papular nodular, hyper pigmented, budding and disseminated appeared after six months of corticosteroid therapy. This treatment was introduced for the treatment of acoustic neurinoma. The patient is not diabetic or alcoholic and has a negative HIV status. The diagnosis of Kaposi's sarcoma was made by histology of biopsied skin lesions which concluded for a regular proliferation without atypia spindle cell or mitosis. The lesions persisted over a month despite discontinuation of corticosteroid therapy. Treatment with Bleomycin was necessary. The outcome was favorable under treatment with progressive and complete disappearance of lesions after 15 treatments. Conclusion: The classical side effects of long-term corticosteroid are known, but Kaposi sarcoma complicating long-term corticosteroid is rare in the literature. It is vital that any long-term corticosteroid should be the subject of careful and regular monitoring.
2017
Kaposi’s sarcoma (KS) is a vascular tumor with different epidemiological, clinical, and morphologic features, and KS-associated herpes virus plays role in its etiology. In the pathogenesis of these tumors, inflammatory, immunological, and oncogenic factors are closely related to each other. Classic KS is characterized by cutaneous lesions and mild clinical course. However, with the addition of various factors to the disease process, KS lesions can occur in unusual locations and cause unexpected clinical symptoms. In this study, we present a case of gastrointestinal system involvement in KS and lymphadenopathic KS following interstitial lung disease and steroid treatment in a 72-year-old male patient who was treated for cutaneous classic KS for 10 years. Histopathologic differential diagnosis of KS lesions seen in unusual localizations is discussed in the context of literature.
Segmental Kaposi Sarcoma in an Immunocompromised Patient
2022
Kaposi sarcoma (KS) is a vascular tumor that classically presents as multiple violaceous lesions on the extremities in a widespread manner. A 60-year-old male with a history of immunosuppression in the setting of bilateral lung transplant presented with numerous violaceous papulonodules and patches localized on the left flank, with a biopsy confirming the diagnosis of KS. We present a rare case of KS presenting in a segmental distribution and review the available literature with a discussion of the possible mechanisms behind segmental and dermatomal KS.
Kaposi's sarcoma: Malignant tumor or proliferative disorder?
European Journal of Cancer and Clinical Oncology, 1988
In order to pouide information on the response to treatments and clinico-pathological pattern, the clinical course of 41 patients mith classic Kaposi's sarcoma (KS) was reconsidered. Twnty-six cases presented a single nodular lesion, and 15 multiple, pluricentric lesions. Surgery was the first treatment,for patients Lth single lesions, 14 of 26 (54%) patients had recurrences: the disea.re-free interual ranged from a few months to 1 1 years. I&e cases had disseminated disease, three of these were preceded by local recurrence. Cases with multiple lesions were treated by a combination of .surgery, chemo-and radiation therapy (RT). In three cases spontaneous regression of disease toas observed and two of these are presently disease-free. After chemotherapy and RT, many patients had com$ete remission of disseminated disease for up to 40 months. The drugs of first choice Lelere vinblastine and bleomycin. Oiler all, only one patient died of KS, 10 years after diagnoses. never-theless the cure rate was very poor and the ,final overall disease-free rate was around 30% Proper treatmentfor nodular or di.tseminated lesions provides a fair disease-,free period. Final considerations: mortality of disease is exceptional despite the 80% risk of recurrence or dissemination. Data from our series do not provide proof that adequute control of the primary .single lesion could screen against recurrence: the interaal between treatment of the first lesion and recurrence is sometimes exceptionally long, up to more than 10 years, andfor that it is not ea.sy to state mhen disease is really cured. These considerations and other analogies betreeen KS and lymphoproliferative disorders in immunodepressed people strongly suggests the possibilitJ! of a non-malignant or even non-tumoral pattern to this disease, with implications for therapeutic strategies.
A Case of Non-cutaneous Kaposi Sarcoma
Cureus
Kaposi sarcoma is a malignancy common in patients with acquired immune deficiency syndrome (AIDS). It is a proliferative soft-tissue tumor commonly manifesting as pigmented papules and nodules on the skin. Lesions can also appear on the mucosal lining of the oropharynx and other parts of the body such as the lymph nodes. Head and neck involvement in Kaposi sarcoma is not unusual; however, laryngeal involvement is not commonly seen. We report the case of a 31-year-old gentleman, a former smoker with AIDS, who developed a mass in the throat with progressive hoarseness of voice without stridor. An elective tracheostomy was done to protect his airway before performing a direct laryngoscopy with biopsy. Histopathology examination showed neoplastic spindle cells positive for CD31, erythroblast transformation specific-related gene, and human herpesvirus 8, consistent with Kaposi sarcoma. The diagnosis of laryngeal Kaposi sarcoma in immunodeficient patients requires a high index of suspicion, especially when it occurs without classical dermatological manifestation, an interesting feature in this report.
Kaposi's sarcoma - still an enigma
Journal of the European Academy of Dermatology and Venereology, 2003
Kaposi's sarcoma (KS) is an unusual neoplasm that has proved to be an enigma in many ways since its original description in 1872. KS, a vascular tumour that is otherwise rare, is at present the most common neoplasm in patients with AIDS. The lesions contain spindle cells that share features with endothelial cells and smooth muscle cells and are in all likelihood primitive mesenchymal cells that can form vascular channels. These cells are monoclonal in origin indicating therefore that KS is a neoplasm. The presence of a novel type of human herpes virus, KS herpesvirus (KSHV) also called human herpesvirus type 8 (HHV8) in KS lesions support a viral ethiology. KS may be mistaken in the skin for an inflammatory or other lesion, thus skin biopsy is important for correct diagnosis, with the use of immunohistochemistry or molecular biology if needed. Radiation or interferon alpha dominate in the therapeutic approaches.
Classic Kaposi sarcoma with sarcoid-like granulomas: A case report and literature review
Experimental and Molecular Pathology, 2009
The occurrence of granulomatous reactions within lymph nodes that drain carcinomas is well known but uncommon. Even more rarely, granulomas may occur within the stroma of tumors. These lesions, called sarcoid-like reactions, commonly accompany carcinomas but are very rare in sarcomas. This study presents a case of classic Kaposi sarcoma that contained sarcoid-like granulomas, with a literature review. A soft tissue lesion of the foot was excised from a 74-year-old male. Histopathological examination showed that the tumor tissue consisted of spindle cells, areas of atypical vascular proliferation, and extravasated erythrocytes surrounded by non-caseating granulomas. The patient had no clinical or laboratory findings of sarcoidosis. The case was interpreted as "Kaposi sarcoma containing sarcoid-like granulomas". The association of soft tissue sarcomas with a granulomatous reaction is very rare. A granulomatous reaction is reported to be a good prognostic indicator in several carcinoma types, although its importance in sarcomas is unclear.
Mucosal involvement in classic Kaposi's sarcoma
British Journal of Dermatology, 2003
In summary, we have demonstrated that APD encompasses a variety of perforating disorders and further support that, at least in the setting of renal failure and diabetes, these disorders are all manifestations of one disease process. Perhaps this conclusion could also be drawn in the article by Karakas et al. 1 if the histopathology of multiple lesions were explored.