Kaposi's Sarcoma

Background

• Angioproliferative disorder caused by HHV-8
• Divided into four types based on clinical circumstance
  • Classic - typically presents in middle or old age
  • Endemic - endemic in sub-Saharan Africa
  • Iatrogenic - associated with immunosuppressive therapy
  • AIDS-associated

Clinical Features

• Skin Lesions
  • Purplish, reddish blue, or brown macules, plaques, and nodules on the skin
  • Ranging from very small to several cm in diameter
  • May rapidly evolve and disseminate or remain unchanged over time

• Extracutaneous Manifestations
  • Involvement of the mouth and GI tract
  • Often asymptomatic but may cause bleeding or diarrhea

• Chronic, indolent course rarely influencing survival

Differential Diagnosis

• Peripheral vascular disease
• Bacillary angiomatosis
• Angiosarcoma
• Hemangioma

Diagnosis

• Biopsy is required for definitive diagnosis
• PCR of skin sample for HHV-8

Management

• Primary goals of treatment: palliation, alleviating lymphedema, improving function, decreasing the size of cutaneous or visceral lesions, and delaying or preventing disease progression
• Surgery may be considered for singular lesions
• Radiation is effective though controversial
• Cryotherapy for local control, though effect is largely cosmetic

Disposition

• Follow up for outpatient treatment

References

<UpToDate>