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Kaposi’s sarcoma

Definition

Kaposi's sarcoma is a cancerous tumor of the connective tissue, and is often associated with AIDS.

Causes, incidence, and risk factors

Before the AIDS epidemic, Kaposi's sarcoma was seen mainly in elderly Italian and Jewish men, and rarely, in elderly women. Among this group, the tumors developed slowly. In AIDS patients, the cancer can develop quickly. The cancer may also involve the skin, lungs, gastrointestinal tract, and other organs.

In people with AIDS, Kaposi's sarcoma is caused by an interaction between HIV, a weakened immune system, and the human herpesvirus-8 (HHV-8). Kaposi's sarcoma has been linked to the spread of HIV and HHV-8 through sexual activity.

People who have kidney or other organ transplants are also at risk for Kaposi's sarcoma.

African Kaposi's sarcoma is fairly common in young adult males living near the equator. One form is also common in young African children.

Symptoms

The tumors most often appear as bluish-red or purple bumps on the skin. They are reddish-purple because they are rich in blood vessels.

The lesions may first appear on the feet or ankles, thighs, arms, hands, face, or any other part of the body. They also can appear on sites inside the body.

Other symptoms may include:

• Bloody sputum
• Shortness of breath

Signs and tests

The following tests may be performed to diagnose Kaposi's sarcoma:

• Bronchoscopy
• CT scan
• Endoscopy
• Skin biopsy

Treatment

How this condition is treated depends on:

• How much the immune system is suppressed (immunosuppression)
• Number and location of the tumors
• Symptoms

Treatments include:

• Antiviral therapy against the AIDS virus
• Combination chemotherapy
• Freezing (cryotherapy)
• Radiation therapy

Lesions may return after treatment.

Support Groups

Expectations (prognosis)

Treating Kaposi's sarcoma does not improve the chances of survival from AIDS itself. The outlook depends on the person's immune status and how much of the HIV virus is in the patient's blood (viral load).

Complications

Complications can include:

• Cough (possibly bloody) and shortness of breath if the disease is in the lungs
• Leg swelling that may be painful or cause infections if the disease is in the lymph nodes of the legs

The tumors can return even after treatment. Kaposi's sarcoma can be deadly for a person with AIDS.

An aggressive form of African Kaposi's sarcoma can spread quickly to the bones. Another form found in African children does not affect the skin. Instead, it spreads through the lymph nodes and vital organs, and can quickly become deadly.

Calling your health care provider

Prevention

Safe sexual practices can prevent HIV infection. This prevents AIDS and its complications, including Kaposi's sarcoma.

References

Volberding PA. Hematology and oncology in patients with human immunodeficiency virus infection. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 416.