Kaposi’s sarcoma after liver transplantation: case report Sarcoma de Kaposi pós-transplante hepático: relato de caso (original) (raw)
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Sarcoma de Kaposi pós-transplante hepático: relato de caso
Revista de Medicina, 2022
Introduction: Kaposi's Sarcoma is a multicentric malignant neoplasm characterized by the development of purple tumors, which can be seen on the skin and subcutaneous tissue and on viscera. The objective of this study was to report a case of Kaposi's Sarcoma after liver transplantation, considering the rarity of this event. Method: The research instrument used to conduct this report was the case study, with collection of information from the patient's physical record. Case report: A 28-year-old man with a history of using Tacrolimus for three years due to liver transplantation, presented abdominal pain associated with diarrhea, and was diagnosed with Kaposi's Sarcomi through histopathological examination of intestinal polyp and referred for chemotherapy treatment. Final considerations: Patients who were submitted to solid organ transplants and treated with immunodepressive medications should have any new symptoms carefully investigated to allow an early diagnosis of neoplasia.
Imaging of Kaposi sarcoma in a transplanted liver: A rare case report
The Egyptian Journal of Radiology and Nuclear Medicine, 2015
In post-transplant patients, de novo malignancies such as post-transplant lymphoproliferative disease (PTLD), lung carcinoma, renal cell carcinoma, cutaneous malignancies, and Kaposi sarcoma are now seen. The immunotherapy used to prevent graft failure indirectly increases their risk. We present a rare case of visceral Kaposi sarcoma in a patient with orthotopic liver transplant.
Liver Transplantation and Surgery, 1997
Kaposi's sarcoma (KS) is a common malignancy in patients with acquired immunodeficiency syndrome (AIDS), classically appearing as red to purple plaques containing small papules and nodules. We report our experience with an adolescent orthotopic liver transplant recipient who presented with an unusual presentation of KS. The patient had a protracted multisystem illness that began with hemolytic anemia, fevers, and fatigue and progressed to pancreatitis, sinusitis, lymphadenopathy, and mouth ulcers. The diagnosis was made by a lymph node biopsy that was performed to evaluate for Epstein-Barr virus. The classical subcutaneous nodules characteristic of KS did not become evident until shortly before the patient died. We present this case to emphasize that KS in pediatric liver transplant patients can present as a multisystem disease that progresses to disseminated organ involvement before the characteristic subcutaneous manifestations are evident.
Transplantation, 2010
Background. Kaposi's sarcoma (KS) is an infrequent vascular neoplasm commonly diagnosed as an isolated cutaneous lesion that can involve other organs. So far, there are no data in the literature about the development of KS after intestinal transplant. Methods. In this study, the authors describe a case of "visceral KS" with pulmonary and intestinal involvement and perform a systematic literature review of case reports and single-center series identified in MEDLINE. Results. This case was a 42-year-old man, diagnosed with visceral KS 9 months after receiving an isolated intestinal transplant. He was successfully treated with a combination of sirolimus and liposomal doxorubicin and achieved an 18-month disease-free survival. A total of 54 cases from 27 manuscripts and the present case were analyzed in this study. The mean time from transplant to diagnosis was 17.2 months. Lungs and gastrointestinal tract were the main organs involved. Immunosuppressants were discontinued in two of the three (66.7%) cases, and sirolimus was added in eight cases. Doxorubicin was used in 12 cases. In a univariate analysis, the use of Tacrolimus, type of transplant, and presence of cutaneous KS seem to be the significant predictors of response to therapy and survival; the addition of doxorubicin showed a reduction in graft loss. Conclusions. Treatment of KS in posttransplant patients should be designed aiming to obtain a complete response, irrespective of the organ affected. Only recipients who are able to achieve a sustained response would be able to obtain long-term disease-free survival.
Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study
Journal of the American Academy of Dermatology, 2019
Background: Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors and/or chemotherapy. Objective: To obtain an overview of clinical strategies about the current treatment of KS. Methods: We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Results: Ninety five percent, 28% and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. Overall, 83% of patients had response at 6 months including 40% complete responses (CR). Limitations: The retrospective design of the study. Conclusion: Currently available therapeutic options seem to be effective to control KS in a majority of patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.
Unusual site of kaposi sarcoma after kidney transplantation
Iranian journal of kidney diseases, 2012
Kaposi sarcoma (KS) is the most common cancer after kidney transplantation in the Middle East countries. 1 The prevalence of KS in comparison with other tumors is also quite higher in Iranian recipients. 1,2 However, squamous cell carcinoma of the skin is the most common posttransplant malignancy in other reports. 1,3,4 Its incidence following kidney transplantation has steadily increased due to the long-term use of potent i m m u n o s u p p r e s s i v e d r u g s f o r p r e v e n t i o n of allograft rejection. 1,3,5 The prevalence of posttransplant KS varies in different geographic areas, most cases reported from Mediterranean descent, suggesting the importance of ethnic or environmental factors in its development. 1,3,6 Several investigators have found that the higher levels of anti-human herpesvirus-8 antibodies in the Middle East region where there is a higher prevalence of KS. 1 In the current issue of the Iranian Journal of Kidney Diseases a solitary laryngeal KS in a kidney transplant recipient is reported by Taheri and coworkers as an unusual involvement. 7 The patient who was a 40-year-old man presented with severe hoarseness after 21 months of his transplantation. It is important to note that 90% of kidney transplants with KS have skin lesions, mucosal lesions, or both. The oropharyngeal and conjunctival mucosa may be affected. Purely visceral involvement happens in 10% of recipients and their clinical manifestations are unusual. 1 Visceral disease predominantly affects the lymph nodes, gastrointestinal tract, and
Incidence and Management of Kaposi Sarcoma in Renal Transplant Recipients: The Greek Experience
Transplantation Proceedings, 2014
Objective. One of the most common malignancies in kidney transplant recipients is Kaposi sarcoma. The incidence of Kaposi sarcoma, which develops after renal transplantation, is 400e500 times higher than that in the general population. The aims of this study were to review the experience with Kaposi sarcoma in the highest-volume transplantation Unit in Greece and to analyze clinical characteristics and response to treatment, with respect to both the patients' survival and the renal graft function. Materials and Methods. The records of 2008 renal graft recipients between March 1983 and December 2012 were retrospectively reviewed. Kaposi sarcoma was diagnosed based on clinical, laboratory, radiological, endoscopic, and histopathologic examinations. The disease was staged according to the classification of Al-Khader et al. Results. The prevalence of Kaposi sarcoma was 1.2% in our renal transplant population. Of these, 1006 recipients underwent living-donor renal transplantation, whereas 1002 received their graft from deceased donors. Post-transplantation malignancy developed in 153 patients, among which, Kaposi sarcoma has been found in 24 cases. Of the 24 cases of Kaposi sarcoma, lesions were mainly cutaneous in 14 cases, visceral and cutaneous in 8, and concomitant visceral and lymph node involvement was observed in 2 patients. With regard to the final outcome, 20 patients (83.3%) showed remission of the disease, whereas 4 patients with visceral involvement (16.6%) did not respond to chemotherapy and discontinuation of immunosuppression and died. Moreover, 8 deaths occurred due to apparently unrelated causes. Conclusions. Kaposi sarcoma is an important part (15.7%) of all post-transplantation neoplasias in our series. Furthermore, our findings confirmed the previously described close association between human herpesvirus-8 and post-transplantation Kaposi sarcoma. Reduction of immunosuppression or discontinuation of calcineurin inhibitors results in remission of the disease in most of the cases. Prognosis in patients with Kaposi sarcoma limited to the skin is favorable, whereas visceral involvement is associated with high mortality. G.Z. and D.M. equally contributed to this article.
Isolated intestinal Kaposi’s sarcoma in a kidney transplant patient: Diagnostic difficulty
Nephro-urology monthly, 2011
A 33 year old man with unknown cause of end stage renal disease received a renal graft from a deceased donor. Triple immunosuppression with cyclosporine A (CyA), mycophenolate mofetil and prednisone was prescribed. Four months after transplantation the patient developed general weakness, fever, diarrhea and bleeding to the intestinal tract leading to severe anemia. Due to the fact that no bleeding site was found during gastroduodenoscopy and colonoscopy, open surgery was performed and revealed bleeding ulcerations in small intestine. Partial resection of small intestine and hemicolectomy was performed and histopathological examination revealed Kaposi’s sarcoma (KS) infiltration in the ulceration. CyA was withdrawn and rapamycine started. After 4 years post surgery the patient has been doing well, without symptoms of KS. ARTICLE INFO