Kaposi Sarcoma

What is the cell of origin

Lymphatic vascular endothelial cells in the skin

What is the aetiology

Human HerpesVirus 8 (HHV8) Infection

Not considered a true sarcoma, which is a tumor arising from mesenchymal tissue

arises as a cancer of lymphatic and vascular endothelium

characteristic abnormal elongated shape, called spindle cells. highly vascular, containing abnormally dense and irregular blood vessels, which leak red blood cells into the surrounding tissue and give the tumor its dark color. Inflammation around the tumor may produce swelling and pain. Detection of the KSHV protein LANA in tumor cells confirms the diagnosis.

What are the clinical presentations

Four subtypes

Classic – indolent Cutaneous form affecting elderly Mediterranean or Jewish men

Endemic African – all parts of Africa, young pts and not related to HIV, aggressive

Organs Transplant recipient - due to cyclosporine (calcineurin inhibitors)

Epidemic - HIV-associated

What are the Viscera manifestations

            Manifestation of HIV-associated KS

                        Oral mucosa

                        GIT Tract

                        Respiratory Tract

What are the Cutaneous manifestations

Most often on lower extremity, also in back, face, genitalia

Papular elliptical arranged in a linear fashion along the lines of relaxed skin tension

Not painful or pruritic and no necrosis

Lesions vary in colour from pink to red, purple and brown

What is the treatment

For AIDS patients – HAART (Highly Active AntiRetroviral Therapy)

For patients with limited symptomatic disease: Local therapy – intra-lesional chemotherapy for small       lesions and radiotherapy for larger lesions

For extensive Cutaneous disease or visceral involvement – chemotherapy with liposomal           anthracycline

        Surgery not recommended as it will reoccurs on the wound edge