Kaposi's sarcoma

Kaposi's sarcoma, multiple haemorrhagic sarcoma
Characteristic purple lesions of Kaposi's sarcoma on the nose of an HIV-positive female.[1]
Pronunciation
SpecialtyOncology
SymptomsPurple colored skin lesions[4]
TypesClassic, endemic, immunosuppression therapy-related, epidemic[4][5]
Risk factorsHuman herpesvirus 8 (HHV8), poor immune function[4][6]
Diagnostic methodTissue biopsy, medical imaging[4][6]
Differential diagnosisBlue rubber bleb nevus syndrome, pyogenic granuloma, melanocytic nevi, melanoma[6]
TreatmentSurgery, chemotherapy, radiation therapy, biologic therapy[4]
Frequency42,000 (new cases, 2018)[7]
Deaths20,000 (2018)[7]

Kaposi's sarcoma (KS) is a type of cancer that can form masses on the skin, in lymph nodes, in the mouth, or in other organs.[4][6] The skin lesions are usually painless, purple and may be flat or raised.[6][8] Lesions can occur singly, multiply in a limited area, or may be widespread.[6] Depending on the sub-type of disease and level of immune suppression, KS may worsen either gradually or quickly.[6] Except for Classical KS where there is generally no immune suppression, KS is caused by a combination of immune suppression (such as due to HIV/AIDS) and infection by Human herpesvirus 8 (HHV8 – also called KS-associated herpesvirus (KSHV)).[8]

Classic, endemic, immunosuppression therapy-related (also known as iatrogenic), and epidemic (also known as AIDS-related) sub-types are all described.[8] Classic KS tends to affect older men in regions where KSHV is highly prevalent (Mediterranean, Eastern Europe, Middle East), is usually slow-growing, and most often affects only the legs.[8] Endemic KS is most common in Sub-Saharan Africa and is more aggressive in children, while older adults present similarly to classic KS.[8] Immunosuppression therapy-related KS generally occurs in people following organ transplantation and mostly affects the skin.[8] Epidemic KS occurs in people with AIDS and many parts of the body can be affected.[8] KS is diagnosed by tissue biopsy, while the extent of disease may be determined by medical imaging.[4][6][8]

Treatment is based on the sub-type, whether the condition is localized or widespread, and the person's immune function.[6] Localized skin lesions may be treated by surgery, injections of chemotherapy into the lesion, or radiation therapy.[6] Widespread disease may be treated with chemotherapy or biologic therapy.[4][6] In those with HIV/AIDS, highly active antiretroviral therapy (HAART) prevents and often treats KS.[8][9] In certain cases the addition of chemotherapy may be required.[9] With widespread disease, death may occur.[6]

The condition is relatively common in people with HIV/AIDS and following organ transplant.[6][8][9] Over 35% of people with AIDS may be affected.[10] KS was first described by Moritz Kaposi in 1872.[11][12] It became more widely known as one of the AIDS-defining illnesses in the 1980s.[11] KSHV was discovered as a causative agent in 1994.[11][13]

  1. ^ Sand M, Sand D, Thrandorf C, Paech V, Altmeyer P, Bechara FG (June 2010). "Cutaneous lesions of the nose". Head & Face Medicine. 6: 7. doi:10.1186/1746-160X-6-7. PMC 2903548. PMID 20525327.
  2. ^ Collins English Dictionary – Complete and Unabridged, 12th Edition 2014. S.v. "Kaposi's sarcoma." Retrieved August 15, 2017 from http://www.thefreedictionary.com/Kaposi's+sarcoma
  3. ^ Random House Kernerman Webster's College Dictionary. S.v. "Kaposi's sarcoma." Retrieved August 15, 2017 from http://www.thefreedictionary.com/Kaposi's+sarcoma
  4. ^ a b c d e f g h "Kaposi Sarcoma Treatment". National Cancer Institute. 16 June 2017.
  5. ^ Schneider JW, Dittmer DP (August 2017). "Diagnosis and Treatment of Kaposi Sarcoma". American Journal of Clinical Dermatology. 18 (4): 529–539. doi:10.1007/s40257-017-0270-4. PMC 5509489. PMID 28324233.
  6. ^ a b c d e f g h i j k l m Schwartz RA, Micali G, Nasca MR, Scuderi L (August 2008). "Kaposi sarcoma: a continuing conundrum". Journal of the American Academy of Dermatology. 59 (2): 179–206, quiz 207–8. doi:10.1016/j.jaad.2008.05.001. PMID 18638627.
  7. ^ a b The Global Cancer Observatory (2019). "Kaposi sarcoma" (PDF). Retrieved 14 March 2020.
  8. ^ a b c d e f g h i j Cesarman E, Damania B, Krown SE, Martin J, Bower M, Whitby D (January 2019). "Kaposi sarcoma". Nature Reviews. Disease Primers. 5 (1): 9. doi:10.1038/s41572-019-0060-9. PMC 6685213. PMID 30705286.
  9. ^ a b c Hoffmann C, Sabranski M, Esser S (2017). "HIV-Associated Kaposi's Sarcoma". Oncology Research and Treatment. 40 (3): 94–98. doi:10.1159/000455971. PMID 28259888. S2CID 9700628.
  10. ^ Ferri FF (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 735. ISBN 9780323529570.
  11. ^ a b c "Kaposi Sarcoma Treatment". National Cancer Institute. 1 October 2015. Retrieved 18 December 2017.
  12. ^ Kaposi M (1872). "Idiopathisches multiples Pigmentsarkom der Haut". Archiv für Dermatologie und Syphilis. 4 (2): 265–273. doi:10.1007/BF01830024. S2CID 31438763.
  13. ^ Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS (December 1994). "Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma". Science. 266 (5192): 1865–1869. Bibcode:1994Sci...266.1865C. doi:10.1126/science.7997879. PMID 7997879. S2CID 29977325.