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Kaposi sarcoma

Last reviewed: 11 Apr 2025
Last updated: 10 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • age >50 years
  • male sex
  • geographic location: central Africa or the Mediterranean
  • HIV infection
  • human herpesvirus-8 (HHV-8, also known as Kaposi sarcoma-associated herpesvirus [KSHV]) infection
  • immunosuppression
  • skin lesion
  • oral lesion
  • lymphadenopathy
  • lymphedema
Full details

Other diagnostic factors

  • weight loss
  • abdominal pain
  • gastrointestinal (GI) bleeding
  • diarrhea
  • dyspnea
  • hemoptysis
  • chest pain
  • fever
Full details

Risk factors

  • male sex
  • HIV infection
  • immunosuppressive therapy
  • human herpesvirus-8 (HHV-8, also known as Kaposi sarcoma-associated herpesvirus [KSHV]) infection
  • central African ethnicity
  • drug abuse
  • Jewish ethnicity
  • Mediterranean ethnicity
  • age <5 years or >50 years
  • men who have sex with men
  • Black American ethnicity
Full details

Diagnostic tests

1st tests to order

  • HIV test
  • CBC and comprehensive metabolic panel
  • skin/mucosal biopsy
Full details

Tests to consider

  • chest x-ray
  • chest CT and bronchoscopy
  • CT abdomen/pelvis
  • MRI
  • fecal occult blood
  • gastrointestinal (GI) endoscopy
  • PET scan
  • lymph node biopsy
  • renal function tests
  • liver function tests
Full details

Emerging tests

  • human herpesvirus-8 (HHV-8) viremia and serology

Treatment algorithm

ACUTE

HIV-associated KS

classic (sporadic) KS

iatrogenic (transplant-related) KS

endemic (observed in sub-Saharan Africa) KS

Contributors

Authors

David Aboulafia, MD

Attending Hematologist and Oncologist

Virginia Mason Clinical Professor of Medicine

Division of Hematology and Oncology

University of Washington

Seattle

WA

Disclosures

DA is the author of articles cited in this topic.

Acknowledgements

Dr David Aboulafia would like to gratefully acknowledge Dr Liron Pantanowitz and Dr Bruce J. Dezube, previous contributors to this topic.

Peer reviewers

Justin Stebbing, MA, MRCP, MRCPath, PhD

Consultant Medical Oncologist/Senior Lecturer

Department of Medical Oncology

Imperial College/Imperial Healthcare NHS Trust

Charing Cross Hospital

London

UK

Disclosures

JS declares that he has no competing interests.

Thierry Simonart, MD, PhD

Physician

Department of Dermatology

Erasme University Hospital

Brussels

Belgium

Disclosures

TS declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Kaposi sarcoma [internet publication].Full text

Lebbe C, Garbe C, Stratigos AJ, et al; European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organisation for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). Eur J Cancer. 2019 Jun;114:117-27. Abstract

National Institutes of Health, Centers for Disease Control and Prevention, and HIV Medicine Association of the Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. 2024 [internet publication].Full text

National Institutes of Health, Centers for Disease Control and Prevention, and HIV Medicine Association of the Infectious Diseases Society of America. US Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. 2024 [internet publication].Full text

World Health Organization. Guidelines on the treatment of skin and oral HIV-associated conditions in children and adults. Jan 2014 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Guidelines

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    • Kaposi sarcoma treatment (PDQ)
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