Eyelid Kaposi Sarcoma in an HIV-negative Patient

A rare case of bilateral conjunctival Kaposi's sarcoma in a HIV-negative patient

PURPOSE

Kaposi's sarcoma (KS) is a rare multi-centric vascular neoplasm, first described by Moritz Kaposi in 1872. It can appear in four different forms: classic, endemic, HIV-related and post-transplant form. We present an uncommon case of seronegative HIV infection patient with skin KS involving conjunctiva of both eyes.

OBSERVATIONS

Firstly, right eye lesions were surgically removed. Subsequently, the patient was administered with systemic chemotherapy (doxorubicin) to treat both skin and left eye lesions. No signs of recurrence were observed at 20 months' follow-up.

CONCLUSIONS

Both eyes involvement in KS is rarely described in scientific literature. Both surgery and chemotherapy could be considered valid treatment options for conjunctival KS.

Diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma: Italian recommendations

Kaposi's sarcoma (KS) is a lymphangioproliferative disorder associated with Human herpesvirus 8 (HHV8) infection. Four clinical subtypes are recognized: classic, endemic, epidemic (HIV-related) and iatrogenic. KS diagnosis is based on clinical features, histopathological assessment, and HHV8 serology. Classic KS is usually skin-limited and has a chronic course, while the iatrogenic variant may show mucosal, nodal or visceral involvement. Clinical staging is fundamental to guide the management. Localized disease may be treated with different local therapies, even if there are no randomized trials comparing these different modalities. Aggressive, disseminated KS and cases with visceral involvement usually require systemic chemotherapy, most commonly vinblastine, bleomycin or paclitaxel. Iatrogenic KS needs immunosuppression tapering/withdrawal and, if possible, switch to m-TOR inhibitors in post-transplant KS. The present work by a panel of Italian experts provides guidelines on KS diagnosis and management based on a critical review of the literature and a long and extensive personal experience.

Total resolution of ocular Kaposi sarcoma with different treatment approaches - a case series and review of literature

Kaposi sarcoma (KS) is an angioproliferative disease that can vary from low-grade to aggressive and lethal multicentric vascular lesions, which can involve various locations, commonly mucocutaneous, lymph nodes, and visceral organs. It can also involve unusual sites such as the eye, central or peripheral nervous system, larynx, and many other anatomical sites. We describe three cases of ocular KS, which resolved completely following different treatment modalities. All three cases were known HIV-positive individuals with low CD4 cell counts. Case 1 received pegylated doxorubicin, case 2 received local radiotherapy, and case 3 received only highly active antiretroviral therapy (HAART). All three cases responded well to their respective therapy. Ocular KS is generally responsive to treatment. Initiation of HAART can achieve a remarkable response. In large or resistant cases, other treatment modalities can be considered to achieve resolution of lesions.