Kaposi's sarcoma of the head and neck in acquired immunodeficiency syndrome

AIDS-related primary Kaposi sarcoma of the nasopharynx

Primary nasopharyngeal Kaposi sarcoma is extremely rare, as only 1 case has been previously reported in the literature. We report a new case, which occurred in a 37-year-old man with a known history of acquired immune deficiency syndrome (AIDS). The patient presented with complaints of recurrent epistaxis and postnasal hemorrhage. Endoscopic examination detected a bluish, smooth, firm, nonpulsatile mass in the nasopharyngeal wall. Histopathologic findings on biopsy were consistent with Kaposi sarcoma. The tumor was successfully treated with radiotherapy. Kaposi sarcoma should be considered in the differential diagnosis of any AIDS patient who presents with recurrent unilateral nasal bleeding.

Venous Outflow Obstruction With Retroperitoneal Kaposi's Sarcoma and Treatment With Inferior Vena Cava Stenting

A 26-year-old man presented with acute renal insufficiency, and severe lower extremity swelling. Computed tomographic scan revealed retroperitoneal lymphadenopathy encasing both ureters and the inferior vena cava. He underwent placement of ureteral stents to relieve the obstruction and afterward underwent lymph node biopsy, which revealed Kaposi's sarcoma. He subsequently was diagnosed with acquired immunodeficiency syndrome. Abdominal and lower extremity venous duplex ultrasound did not show any evidence of deep vein thrombosis. The inferior vena cava measured 3.5 mm in diameter and was encased by retroperitoneal lymphadenopathy. Bilateral transfemoral venography and intravascular ultrasound demonstrated significant compression of the inferior vena cava below the renal veins. Endovascular treatment was followed with primary stenting under intravascular ultrasound guidance. His symptoms improved with reduction in swelling. At 1-year follow-up, the patient was ambulatory with mild symptoms, and on venography the iliac vein and inferior vena cava stents were widely patent.

Dysphonia due to kaposi's sarcoma as the presenting symptom of human immunodeficiency virus

Dysphonia and airway obstruction are rarely caused by Kaposi's Sarcoma (KS). We present the case of a 40 year old man receiving his diagnosis of human immunodeficiency virus (HIV) after presenting with hoarseness caused by laryngeal KS. HIV may contribute to KS growth by stimulating excess production of angiogenic lymphokines and monokines and by decreasing immune surveillance. Histopathology reveals proliferating endothelial cells, fibroblasts, thin vascular slits, and extravasated erythrocytes. A wide variety of localized treatment options exist, while chemotherapeutic agents and alpha-interferon are used for multifocal or widespread disease.

Kaposi's sarcoma of the larynx

Kaposi's sarcoma (KS) is a neoplastic vascular disorder, classically arising in the skin of the lower extremities. As a consequence of the acquired immunodeficiency syndrome (AIDS) epidemic, an increasing number of patients have been found to have KS. In AIDS patients, KS appears to exhibit a more diffuse nature and frequently affects the head and neck. Mucosal lesions are most often seen, commonly involving the oral cavity. Only rare cases of laryngeal involvement have been recorded in the literature. We report 2 cases of KS of the supraglottic larynx. Our first patient, an elderly man of Mediterranean descent, complained of voice change and throat discomfort. Endoscopy with biopsy for diagnosis allowed conservative treatment with chemotherapy. Our second patient was a younger man with AIDS who presented with symptoms of airway obstruction. Management with carbon dioxide laser epiglottectomy was successful in relieving that patient's symptoms. Although rare, KS may present in both healthy and immunocompromised patients, and must be considered in the differential diagnosis of all violaceous lesions of the larynx.

Presence of human herpesvirus-like DNA sequence in oral Kaposi's sarcoma. A preliminary PCR study

DNA sequences closely related to herpesvirus-like sequences have been found in AIDS-associated Kaposi's sarcoma. Subsequent studies indicate that these DNA sequences may be consistently found in AIDS Kaposi's sarcoma and non-AIDS Kaposi's sarcoma from different geographic regions. Oral Kaposi's sarcoma is rare and the specificity of this viral DNA in oral Kaposi's sarcoma and in other oral neoplasms has not been examined. A total of 77 oral neoplasms, including 3 Kaposi's sarcoma specimens from 2 patients with AIDS, were analyzed by polymerase chain reaction for the presence of this herpesvirus-like DNA sequence with the 330-233 primers. All three specimens of oral AIDS-Kaposi's sarcoma from two patients were positive for this DNA sequence. All of the other intraoral lesions including hemangioma, pyogenic granuloma, and various types of epithelial neoplasms, however, had negative reactions. Our results further confirm that oral Kaposi's sarcoma appears to be associated with this herpesvirus-like DNA sequence.