Kaposi Sarcoma, KS

Notes
  • This is the most prevalent soft tissue sarcoma that is closely associated with HIV (20,000 times more common than in HIV negative cases)
  • It is associated with Human herpes virus 8, HHV8 (Kaposi’s sarcoma-associated herpes virus, KSHV).
  • Classes of KP:

♦ Classic KS

♦ AIDS-associated (epidemic) KS

♦ Endemic KS

  • Statistics: Incidence of childhood KS in Kenya - 3.6 cases per million; more prevalent in men; 2015 Nairobi registry KS prevalence - men 3.6/100,000 and women 2.0/100,000).
Symptoms
  • Dermatological, mucosal and visceral sites are affected
  • Reddish to dark purple multifocal skin lesions (flat, raised or nodular)
  • Nodules may penetrate soft tissue and proceed to invade bone
  • Peri-orbital oedema
  • peri-orbital haemorrhages
  • Lymphoedema of the lower limbs
  • GI bleeding
  • Intussusception
  • Weight loss
  • Cough
  • Shortness of breath
  • Haemoptysis
  • Chest pain
  • Pleural effusions.
Diagnosis
  • Biopsy and histology of lesion confirms the diagnosis
  • Bronchoscopy
  • Endoscopy
  • Ultra scan (U/S)
  • CT scan
  • Routine tests such as: FBC, urea, electrolytes, creatinine and LFTs.
Differential
  • Pigmented purpuric dermatoses
  • Angioma
  • Bacillary angiomatosis
  • EBV-associated smooth muscle tumour
  • Haemangioendothelioma
  • Pyogenic granuloma
  • Purpura
Prevention
  • No proven way to completely prevent Kaposi sarcoma
  • Avoid HIV infection
Management
  • ARVs in case of HIV related KP
  • Treatment of co-existing infections such as TB and bacterial infections.
  • Cryotherapy
  • Electrocoagulation
  • Excision
  • Imiquimod ointment
  • KP responds well to chemotherapy and radiation therapy.

##>Chemotherapy includes the following drug:

  • Vincristine and bleomycin is the most preferred regime
  • Vinblastine
  • Doxorubicin
  • Daunorubicin
  • Etoposide
  • Gemcitabine
Drug Index 2.0 is here
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