A low-grade vasoformative neoplasm that is associated with human herpesvirus-8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus [KSHV]) infection.
There are 4 main subtypes of Kaposi's sarcoma: epidemic AIDS-related; classic sporadic; iatrogenic and transplant-associated; and African endemic.
Patients may present with multifocal cutaneous lesions, mucosal lesions, or lymph node or visceral involvement.
Therapy is given for symptom palliation, to prevent disease progression, and for cosmetic reasons.
Kaposi's sarcoma (KS) is a low-grade vasoformative neoplasm associated with human herpesvirus-8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus [KSHV]) infection. Lesions frequently involve mucocutaneous sites, but may become more extensive to involve the lymph nodes and visceral organs. Skin lesions evolve from an early patch, to a plaque, and later to ulcerating tumour nodules.
History and exam
Key diagnostic factors
- presence of risk factors
- age >50 years
- male sex
- geographic location: sub-Saharan Africa or the Mediterranean
- HIV infection
- HHV-8 (also known as Kaposi's sarcoma-associated herpesvirus [KSHV]) infection
- skin lesion
- oral lesion
Other diagnostic factors
- weight loss
- abdominal pain
- GI bleeding
- chest pain
- male sex
- HIV infection
- drug abuse
- immunosuppression therapy
- human herpesvirus-8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus [KSHV]) infection
- central African ethnicity (Uganda, Malawi, Zambia, Zimbabwe, Swaziland)
- Jewish ethnicity
- Mediterranean ethnicity
- age <5 years or >50 years
1st investigations to order
- HIV test
- skin/mucosal biopsy
- lymph node biopsy
- fecal occult blood
Investigations to consider
- CT scan
- GI endoscopy
- PET scan
- renal function tests
- human herpesvirus-8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus [KSHV]) viraemia and serology
epidemic AIDS-related KS
classic sporadic KS
iatrogenic and transplant-associated KS
African endemic KS
David Aboulafia, MD
Attending Hematologist and Oncologist
Virginia Mason Clinical Professor of Medicine
Division of Hematology and Oncology
University of Washington
DA is the author of articles cited in this topic.
Dr David Aboulafia would like to gratefully acknowledge Dr Liron Pantanowitz and Dr Bruce J. Dezube, previous contributors to this topic.
Justin Stebbing, MA, MRCP, MRCPath, PhD
Consultant Medical Oncologist/Senior Lecturer
Department of Medical Oncology
Imperial College/Imperial Healthcare NHS Trust
Charing Cross Hospital
JS declares that he has no competing interests.
Thierry Simonart, MD, PhD
Department of Dermatology
Erasme University Hospital
TS declares that he has no competing interests.
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