BMC Research Notes | |
Classic Kaposi Sarcoma: to treat or not to treat? | |
Giuseppe Tonini3  Angelo Paolo Dei Tos2  Daniele Santini3  Valentina Fausti3  Rosario Francesco Grasso1  Anna Maria Frezza3  Loretta D’Onofrio3  Bruno Vincenzi3  | |
[1] Department of Radiology, University Campus Bio-Medico, via Alvaro del Portillo 21, Rome, Italy;Department of Pathology, General Hospital, P.zza Ospedale 1, Treviso, Italy;Department of Medical Oncology, University Campus Bio-Medico, via Alvaro del Portillo 21, Rome, Italy | |
关键词: Spontaneous regression; Classic Kaposi sarcoma; | |
Others : 1164296 DOI : 10.1186/s13104-015-1076-1 |
|
received in 2013-12-19, accepted in 2015-03-19, 发布年份 2015 | |
【 摘 要 】
Background
Classic Kaposi Sarcoma (KS) is vascular sarcoma, known to be more common in Mediterranean elderly men and characterized by an indolent clinical behavior. To our knowledge, this is the first evidence in literature, describing a spontaneous partial regression in a non-HIV, non-iatrogenic KS.
Case presentation
A 68-years old woman, presenting with weight loss and respiratory symptoms, was diagnosed with a classic KS involving lungs and mediastinal lymph nodes. No skin or mucosal lesions were identified, HIV positivity was ruled out. Due to patient’s choice, she was kept under surveillance with 3-monthly thorax-abdomen-pelvis computed tomography scan (TAP CT). A first reassessment proved progressive disease (PD) associated with symptoms worsening. A new TAP CT, performed at 5 months from the diagnosis, showed stable disease (SD), with a minor reduction in size of mediastinal lymphadenopathies. A further reassessment, performed 5 months later, resulted in a partial response (PR) despite the absence of any medical treatment. Up to date, the disease is in remission, patient is asymptomatic and still on surveillance.
Conclusion
Given the possible indolent behaviour of KS, we believe that close surveillance can represent a valuable approach in selected cases.
【 授权许可】
2015 Vincenzi et al.; licensee BioMed Central.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150414021554771.pdf | 1159KB | download | |
Figure 4. | 32KB | Image | download |
Figure 3. | 34KB | Image | download |
Figure 2. | 123KB | Image | download |
Figure 1. | 32KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
【 参考文献 】
- [1]Moore PS, Chang Y: Detection of herpesvirus-like DNA sequences in Kaposi's sarcoma in patients with and without HIV infection. N Engl J Med 1995, 332:1181-5.
- [2]Antman K, Chang Y: Kaposi's sarcoma. N Engl J Med 2000, 342:1027-38.
- [3]Godoy MC, Rouse H, Brown JA, Phillips P, Forrest DM, Müller NL: Imaging features of pulmonary Kaposi sarcoma-associated immune reconstitution syndrome. Am J Roentgenol 2007, 189:956-65.
- [4]Régnier-Rosencher E, Guillot B, Dupin N: Treatments for classic Kaposi sarcoma: a systematic review of the literature. J Am Acad Dermatol 2013, 68:313-31.
- [5]Akasbi Y, Awada A, Arifi S, Mellas N, El Mesbahi O: Non-HIV Kaposi's sarcoma: a review and therapeutic perspectives. Bull Cancer 2012, 99:92-9.
- [6]Tebbe B, Mayer-da-Silva A, Garbe C, Von Keyserlingk HJ, Orfanos CE: Genetically determined coincidence of Kaposi sarcoma and psoriasis in an HIV-negative patient after prednisolone treatment: spontaneous regression 8 months after discontinuing therapy. Int J Dermatol 1991, 30:114-20.
- [7]Hussein MM, Mooij JM, Roujouleh HM: Regression of posttransplant Kaposi sarcoma after discontinuing cyclosporin and giving mycophenolate mofetil instead. Nephrol Dial Transplant 2000, 15:1103-4.
- [8]Nagy S, Gyulai R, Kemeny L, Szenohradszky P, Dobozy A: Iatrogenic Kaposi's sarcoma: HHV8 positivity persists but the tumors regress almost completely without immunosuppressive therapy. Transplantation 2000, 69:2230-1.
- [9]Dervis E, Demirkesen C: Kaposi's sarcoma in a patient with psoriasis vulgaris. Acta Dermatovenerol Alp Panonica Adriat 2010, 19:31-4.
- [10]Real FX, Krown SE: Spontaneous regression of Kaposi's sarcoma in patients with AIDS. N Engl J Med 1985, 313:1659.
- [11]Aboulafia DM: Regression of acquired immunodeficiency syndrome-related pulmonary Kaposi's sarcoma after highly active antiretroviral therapy. Mayo Clin Proc 1998, 73:439-43.
- [12]Kondo Y, Izumi T, Yanagawa T, Kanda H, Katano H, Sata T: Spontaneously regressed Kaposi's sarcoma and human herpesvirus 8 infection in a human immunodeficiency virus-negative patient. Pathol Int 2000, 50:340-6.
- [13]Douglas JL, Gustin JK, Dezube B, Pantanowitz JL, Moses AV: Kaposi's sarcoma: a model of both malignancy and chronic inflammation. Panminerva Med 2007, 49(3):119-38.
- [14]Brown EE, Whitby D, Vitale F, Marshall V, Mbisa G, Gamache C, et al.: Virologic, hematologic, and immunologic risk factors for classic Kaposi sarcoma. Cancer 2006, 107(9):2282-90.
- [15]Sung JC, Louie SG, Park SY: Kaposi's sarcoma: advances in tumor biology and pharmacotherapy. Pharmacotherapy 1997, 17(4):670-83.
- [16]Galleu A, Fozza C, Simula MP, Contini S, Virdis P, Corda G, et al.: CD4+ and CD8+ T-Cell Skewness in classic Kaposi Sarcoma. Neoplasia 2012, 14(6):487-94.