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Pantanowitz L, Khammissa RAG, Lemmer J, Feller L. Oral HIV-associated Kaposi sarcoma. J Oral Pathol Med 2012; 42:201-7. [DOI: 10.1111/j.1600-0714.2012.01180.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Gasparis AP, Kokkosis A, Labropoulos N, Tassiopoulos AK, Ricotta JJ. Venous Outflow Obstruction With Retroperitoneal Kaposi's Sarcoma and Treatment With Inferior Vena Cava Stenting. Vasc Endovascular Surg 2009; 43:295-300. [DOI: 10.1177/1538574408328666] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
| | - Angela Kokkosis
- Stony Brook University Medical Center, Stony Brook, New York
| | | | | | - John J. Ricotta
- Stony Brook University Medical Center, Stony Brook, New York
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Pantanowitz L, Dezube BJ. Kaposi sarcoma in unusual locations. BMC Cancer 2008; 8:190. [PMID: 18605999 PMCID: PMC2464778 DOI: 10.1186/1471-2407-8-190] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Accepted: 07/07/2008] [Indexed: 11/10/2022] Open
Abstract
Kaposi sarcoma (KS) is a multifocal, vascular lesion of low-grade malignant potential that presents most frequently in mucocutaneous sites. KS also commonly involves lymph nodes and visceral organs. This article deals with the manifestation of KS in unusual anatomic regions. Unusual locations of KS involvement include the musculoskeletal system, central and peripheral nervous system, larynx, eye, major salivary glands, endocrine organs, heart, thoracic duct, urinary system and breast. The development of KS within wounds and blood clots is also presented. KS in these atypical sites may prove difficult to diagnose, resulting in patient mismanagement. Theories to explain the rarity and development of KS in these unusual sites are discussed.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
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Feller L, Wood NH, Lemmer J. HIV-associated Kaposi sarcoma: pathogenic mechanisms. ACTA ACUST UNITED AC 2007; 104:521-9. [PMID: 17142074 DOI: 10.1016/j.tripleo.2006.08.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Accepted: 08/22/2006] [Indexed: 11/16/2022]
Abstract
Kaposi sarcoma (KS) is a multicentric angioproliferative disorder characterized by spindle cell proliferation, neo-angiogenesis, inflammation, and edema. Human herpesvirus (HHV)-8, a gamma-herpesvirus, is a critical factor, but is not alone sufficient for the initiation of KS. Other cofactors such as human immunodeficiency virus (HIV), host-derived cytokines, chemokines, and growth factors are required for the development of KS. Whether HIV-associated KS is a reactive hyperplastic inflammatory lesion or a true neoplasm is still controversial. It is likely that HIV-associated KS begins as a reactive disorder that in some cases progresses to a monoclonal, an oligoclonal, and a polyclonal neoplasm.
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MESH Headings
- Animals
- Cell Transformation, Neoplastic
- Chemokines/biosynthesis
- Cytokines/biosynthesis
- Gene Expression Regulation, Neoplastic
- Growth Substances/biosynthesis
- HIV Infections/complications
- HIV-1/physiology
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/pathogenicity
- Herpesvirus 8, Human/physiology
- Humans
- Inflammation/complications
- Neovascularization, Pathologic/virology
- Receptors, Chemokine/physiology
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/metabolism
- Sarcoma, Kaposi/virology
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Affiliation(s)
- Liviu Feller
- Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa, South Africa
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Konstantinopoulos PA, Goldsztein H, Dezube BJ, Pantanowitz L. Acquired immunodeficiency syndrome related Kaposi's sarcoma eroding the maxillary bone. The Journal of Laryngology & Otology 2007; 122:993-7. [PMID: 17524171 DOI: 10.1017/s0022215107008705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oral involvement is a common manifestation of acquired immunodeficiency syndrome related Kaposi's sarcoma, and it occurs in approximately one-third of afflicted patients. METHODS We report an unusual case of Kaposi's sarcoma of the hard palate which invaded the underlying maxillary bone. RESULTS The patient underwent excisional biopsy and was subsequently treated with localised radiation and systemic chemotherapy including liposomal doxorubicin. CONCLUSIONS The presentation, differential diagnosis, radiographic appearance and management of this serious complication are discussed. Our case highlights the need for a multidisciplinary approach, consisting of ENT, oncology and infectious disease consultation, to ensure appropriate management of maxillofacial, intraosseous, acquired immunodeficiency syndrome related Kaposi's sarcoma.
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Affiliation(s)
- P A Konstantinopoulos
- Division of Hematology Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Noel KE, Mardirossian G, Schneider L. Primary intraosseous kaposi’s sarcoma presenting as an asymptomatic periapical radiolucency: A case report. ACTA ACUST UNITED AC 2007; 103:e65-70. [PMID: 17317238 DOI: 10.1016/j.tripleo.2006.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2005] [Revised: 09/29/2006] [Accepted: 10/06/2006] [Indexed: 11/16/2022]
Abstract
Kaposi's sarcoma (KS) is a common mucocutaneous manifestation of acquired immunodeficiency syndrome (AIDS). Primary bone lesions have been reported but are rare. A 38-year-old African-American male who was human immunodeficiency virus (HIV)-positive appeared for the evaluation of an asymptomatic well-defined radiolucency of the mandibular midline discovered on routine radiographic examination. The adjacent central incisors were asymptomatic, nonmobile, and vital. The overlying mucosa and cortical plate were intact. Excision of the lesion revealed a fleshy, pink-red soft tissue mass with a uniform consistency. Histological examination showed a malignant spindle cell neoplasm containing numerous extravasated erythrocytes. The tumor cells exhibited positive immunohistochemical staining for CD31, CD34, and human herpesvirus 8. One year after surgical procedure, the surgical defect showed radiographic evidence of repair and there was no sign of recurrent tumor. This case represents the fourth reported instance of primary intraosseous involvement of the jaws with KS.
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Affiliation(s)
- Kenson E Noel
- Department of Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Dental School, Newark, NJ, USA.
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Caponetti G, Dezube BJ, Restrepo CS, Pantanowitz L. Kaposi sarcoma of the musculoskeletal system. Cancer 2007; 109:1040-52. [PMID: 17265518 DOI: 10.1002/cncr.22500] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Kaposi sarcoma (KS) of bone and skeletal muscle is unusual. In this report, the authors review 66 published patients with KS who had involvement of the musculoskeletal system reported from 1925 to 2006. In only 3 patients was acquired immunodeficiency syndrome (AIDS)-related KS identified within skeletal muscle. Osseous KS lesions were more frequent and occurred with African, classic, and AIDS-related KS and occurred rarely in transplantation-associated KS. Patients seldom were asymptomatic. They usually had bone pain with limited mobility or infrequently developed serious sequelae like spinal cord compression. Locally aggressive African and classic KS lesions typically involved the peripheral skeleton; whereas, in patients with AIDS, the axial (vertebrae, ribs, sternum, and pelvis) and/or maxillofacial bones more commonly were involved. Almost all patients had concomitant nonosseous KS lesions. Joint involvement was exceptional, and pathologic fractures were not observed. Computed tomography scans and magnetic resonance images were better at detecting osseous KS lesions, which frequently went undetected on plain x-ray films or bone scans. Pathologic diagnosis was important to exclude similar lesions like bacillary angiomatosis. Treatment options, including surgery and, in more recent patients, radiation and/or chemotherapy, had limited success.
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Affiliation(s)
- Gabriel Caponetti
- Department of Pathology, Baystate Medical Center, Tufts School of Medicine, Springfield, Massachusetts 01199, USA
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Kalpidis CDR, Lysitsa SN, Lombardi T, Kolokotronis AE, Antoniades DZ, Samson J. Gingival Involvement in a Case Series of Patients With Acquired Immunodeficiency Syndrome-Related Kaposi Sarcoma. J Periodontol 2006; 77:523-33. [PMID: 16512768 DOI: 10.1902/jop.2006.050226] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This case series presents the polymorphic clinical characteristics of gingival acquired immunodeficieny syndrome (AIDS)-related Kaposi sarcoma (KS), a malignancy that is gradually becoming uncommon in developed nations. An up-to-date overview of the related epidemiology, etiopathogenesis, histopathology, and treatment is provided, along with a pictorial guide to ease clinical diagnosis. METHODS The oral/maxillofacial pathology records at Aristotle University and the University of Geneva were retrospectively reviewed. Thirty-two cases diagnosed with oral AIDS-related KS were retrieved between 1991 and 2004. KS diagnosis was established histologically by incisional biopsies from intraoral lesions. All charts contained clinical oral examination data, radiological images, and detailed photographic records. RESULTS Thirteen patients (12 males and one female) presented with KS gingival involvement (40.6%). Eleven of the male patients were homosexual/bisexual men. The mean age of the patients at the time of intraoral KS diagnosis was 42.1 years, and the mean CD4 cell count was 103 (0 to 481). Gingival epidemic KS presented with various degrees of pigmentation and a wide range of clinical patterns, from relatively flat macules (early stage) to tumors with variable nodular morphology (advanced disease). Solitary or multiple gingival involvement may appear concomitantly with palatal and/or cutaneous lesions. CONCLUSIONS Even though the incidence of intraoral KS had fallen precipitously in developed countries after the mid-1990s, gingival KS should be considered in the differential diagnosis of every pigmented gingival lesion. Periodontists are in a unique position to identify gingival involvement of intraoral KS and facilitate early diagnosis.
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Affiliation(s)
- Christos D R Kalpidis
- Department of Periodontology and Implant Biology, School of Dentistry, Aristotle University, Thessaloniki, Greece
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9
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Lausten LL, Ferguson BL, Barker BF, Cobb CM. Oral Kaposi Sarcoma Associated with Severe Alveolar Bone Loss: Case Report and Review of the Literature. J Periodontol 2003; 74:1668-75. [PMID: 14682665 DOI: 10.1902/jop.2003.74.11.1668] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In AIDS patients who present with an oral neoplasm, Kaposi sarcoma is the tumor most frequently encountered, comprising 50% to 80% of all tumor occurrences. However, oral Kaposi sarcoma associated with erosion of underlying bone is a relatively rare finding. This report and review of the literature documents a case of AIDS-related oral Kaposi sarcoma exhibiting severe bilateral erosion of the maxillary alveolar ridges. METHODS An HIV-seropositive male with extensive maxillary Kaposi sarcoma and associated bilateral alveolar bone erosion presented for dental evaluation subsequent to radiation therapy. Clinical and radiographic examinations were performed. Medical and dental histories were procured and supplemented with consultations from the patient's primary physician and radiation oncologist. Maxillary edentulation with surgical revision for primary closure was the treatment of choice for management of the dentoalveolar pathology. A maxillary immediate treatment denture was designed to obturate anticipated antral communications with the maxillary sinus. RESULTS Surgical and prosthetic treatments were completed, but complicated by an oral-antral perforation that subsequently healed without complication. Soft tissue biopsies obtained during surgery revealed no evidence of residual Kaposi sarcoma. CONCLUSIONS Although AIDS-related oral Kaposi sarcoma is a relatively common finding, erosion of subjacent alveolar bone is uncommon. Treatment of the tumor with subsequent dental reconstruction can be complicated by the severe lack of bone, surgical perforation of the maxillary sinus, and lack of stable teeth to serve as abutments. Significant advances in understanding the pathogenesis of AIDS-related Kaposi sarcoma have occurred in the last decade. HHV-8 and various inflammatory cytokines have been implicated in the pathogenesis and are likely to become the primary targets for therapeutic intervention.
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Affiliation(s)
- Leonard L Lausten
- Department of Special Patient Care, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
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Kühne CA, Heufelder AE, Hofbauer LC. Bone and mineral metabolism in human immunodeficiency virus infection. J Bone Miner Res 2001; 16:2-9. [PMID: 11149485 DOI: 10.1359/jbmr.2001.16.1.2] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C A Kühne
- Division of Gastroenterology, Endocrinology and Metabolism, Zentrum für Innere Medizin, Philipps-University, Marburg, Germany
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Chen HH, Jung YC, Chen TY, Leung HW. Non-AIDS-related primary intraosseous Kaposi's sarcoma: case report and literature review. Acta Oncol 1997; 36:224-7. [PMID: 9140443 DOI: 10.3109/02841869709109235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- H H Chen
- Department of Radiation Oncology, National Cheng Kung University Hospital, Tainan, Taiwan
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LOMBARDO M, GIROLOMONI G, SPINA V, ZAMBRUNO G, GIANNETTI A. Kaposi's sarcoma with primary bone lesions in an HIV-seronegative man. Br J Dermatol 1996. [DOI: 10.1111/j.1365-2133.1996.tb06338.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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LOMBARDO M, GIROLOMONI G, SPINA V, ZAMBRUNO G, GIANNETTI A. Kaposi's sarcoma with primary bone lesions in an HIV-seronegative man. Br J Dermatol 1996. [DOI: 10.1046/j.1365-2133.1996.140875.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Reichart PA. Oral pathology of acquired immunodeficiency syndrome and oro-facial Kaposi's sarcoma. CURRENT TOPICS IN PATHOLOGY. ERGEBNISSE DER PATHOLOGIE 1996; 90:97-123. [PMID: 8791749 DOI: 10.1007/978-3-642-80169-3_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- P A Reichart
- Abteilung für Oralchirurgie und Zahnärztliche Röntgenologie, Universitatsklinikum Charité Medizinische Fakultät der Humboldt-Universitat zu Berlin, Germany
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Flaitz CM, Nichols CM, Hicks MJ. Role of intralesional vinblastine administration in treatment of intraoral Kaposi's sarcoma in AIDS. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1995; 31B:280-5. [PMID: 7492927 DOI: 10.1016/0964-1955(95)00009-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The purpose of this clinical study was to determine the effect of intralesional vinblastine administration on intraoral Kaposi's sarcoma (KS) in AIDS patients. One hundred and forty-four KS lesions in 50 HIV-positive homosexual males (mean CD4 count 64/mm3) were treated periodically with intralesional vinblastine injection (0.1 mg/cm2) until lesion resolution or no further reduction in lesional area. The most common lesion sites were: palate 56% (hard palate 42%, soft palate 14%); gingiva 22% (maxillary 15%, mandibular 7%); and maxillary tuberosity 6%. The mean lesion area was 4.6 cm2 (range = 0.1-35 cm2). Complete resolution occurred in 74%. The mean reduction in lesional area was 93% for all lesions. Lesions with only a partial response (26%) to vinblastine had a mean reduction in the lesional area of 69%. The mean number of treatments was 2.4 (range = 1-6). The recurrence rate was 26% with a mean disease-free period of 12.9 weeks. Recurrence rates were highest for nodular (40%) and purple macular lesions with focal nodularity (36%). The most frequent complications were transient pain (72%), superficial mucosal ulceration (22%) and transient paresthesia (12%). Intralesional vinblastine administration produced complete resolution in a substantial number of intraoral KS lesions and represents a well-tolerated treatment regimen for localised control of intraoral KS lesions. Owing to a 25% recurrence rate, re-evaluation is necessary for treatment of recurrent and new Kaposi's sarcoma lesions.
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Affiliation(s)
- C M Flaitz
- Department of Stomatology, University of Texas-Houston Health Science Center, USA
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Nichols CM, Flaitz CM, Hicks MJ. Primary intraosseous Kaposi's sarcoma of the maxilla in human immunodeficiency virus infection: review of literature and report of case. J Oral Maxillofac Surg 1995; 53:325-9. [PMID: 7532218 DOI: 10.1016/0278-2391(95)90233-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- C M Nichols
- Dental Branch, University of Texas Health Science Center-Houston 77030-0068
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Porter S, Scully C. HIV: the surgeon's perspective. Part 3. Diagnosis and management of malignant neoplasms. Br J Oral Maxillofac Surg 1994; 32:241-7. [PMID: 7947568 DOI: 10.1016/0266-4356(94)90209-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- S Porter
- Joint Department of Oral Medicine, Eastman Dental Institute, London
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Ficarra G, Eversole LE. HIV-related tumors of the oral cavity. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 1994; 5:159-85. [PMID: 7858081 DOI: 10.1177/10454411940050020201] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In HIV-infected patients with AIDS the most frequent malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. In these patients, the natural history of these tumors is quite different from those of HIV-negative subjects. These tumors may present atypical clinical aspects, may be very aggressive, and the coexistence of immunosuppression and opportunistic infections may render their treatment more difficult. The aim of this article is to provide updated information on the epidemiology, pathogenesis, natural history, and management of tumors that develop in the oral cavity of patients with AIDS.
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MESH Headings
- AIDS-Related Opportunistic Infections/epidemiology
- AIDS-Related Opportunistic Infections/etiology
- AIDS-Related Opportunistic Infections/pathology
- AIDS-Related Opportunistic Infections/therapy
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/therapy
- Humans
- Lymphoma, AIDS-Related/epidemiology
- Lymphoma, AIDS-Related/etiology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/therapy
- Mouth Neoplasms/epidemiology
- Mouth Neoplasms/etiology
- Mouth Neoplasms/pathology
- Mouth Neoplasms/therapy
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/therapy
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Affiliation(s)
- G Ficarra
- Institute of Odontology and Stomatology, University of Florence, Italy
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Abstract
Kaposi's sarcoma is the most frequent malignant neoplasm in AIDS, occurring in about 10 percent of all risk groups. This study evaluates the effect of intralesional vinblastine on intraoral Kaposi's sarcoma in 24 HIV-positive, homosexual males with 82 lesions. Complete resolution occurred in nearly 70 percent of the cases.
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Affiliation(s)
- C M Nichols
- Dental Branch, University of Texas Health Sciences Center, Houston
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Reichart PA, Langford-Kuntz A, Pohle HD. Epidemic oro-facial Kaposi's sarcoma (eKS)--report on 124 cases. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1993; 29B:187-189. [PMID: 8298422 DOI: 10.1016/0964-1955(93)90021-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Oro-facial epidemic Kaposi's sarcoma (eKS) was observed in 124 patients (123 homo-/bisexual men, average age 37.9 years, and one 35-year-old transsexual patient). Average survival time was 1 year 9 months (range: 3 months 4 years 6 months). 57.3% of the patients had died. The hard and/or soft palate, gingiva and tongue were most frequently affected, with falling frequency within these locations. Oral manifestations of eKS appear to be common; treatment modalities must be optimised.
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Affiliation(s)
- P A Reichart
- Abteilung für Zahnärztliche Chirurgie/Oralchirurgie (Nord), Freie Universität Berlin
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Tabata M, Langford A, Becker J, Reichart PA. Distribution of immunocompetent cells in oral Kaposi's sarcoma (AIDS). EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1993; 29B:209-13. [PMID: 7905311 DOI: 10.1016/0964-1955(93)90024-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fifteen biopsy specimens of oral AIDS-associated Kaposi's sarcoma (KS), 19 biopsy specimens of uninvolved oral mucosa of HIV-seropositive patients (HIV+) and 22 biopsy specimens of oral mucosa of HIV-seronegative persons (HIV-) were analysed for the distribution of CD4+ and CD8+ lymphocytes and HLA-DR+ cells. The results were statistically evaluated. According to their clinical appearance KS were classified as flat lesions (n = 10) or exophytic tumours (n = 5). KS lesions of both clinical groups as well as uninvolved mucosa of HIV+ patients revealed infiltration with CD4+ cells. In flat, patch-like KS there was a marked increase of CD8+ cells compared to HIV- mucosa, while their numbers decreased in later tumour stages. In both, flat and exophytic KS the number of HLA-DR+ cells was significantly higher than in uninvolved mucosa of HIV+ and HIV- persons. These findings may reflect the local influence of KS growth factors on the inflammatory reaction in the setting of systemic immunosuppression.
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Affiliation(s)
- M Tabata
- Department of Oral and Maxillofacial Surgery, Kagoshima University Dental School, Japan
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