Gastrointestinal Kaposi's Sarcoma: A Case Report

Kaposi's sarcoma (KS) is an angioproliferative neoplasm caused by the infection of human herpesvirus type 8 (HHV-8), associated with HIV infection. The gastrointestinal tract is the most affected extrcutaneous site, presenting various symptoms with significant prognostic implications.

A 38-year-old male, recently diagnosed with HIV (CD4 count of 47 [7%], CD8 count of 462 [70%], viral load 492,597), is undergoing antiretroviral treatment with bictegravir/emtricitabine/tenofovir. An upper endoscopy due to dyspepsia revealed elevated hyperemic lesions in the gastric fundus and body, measuring 8 to 12 mm, with a vascular appearance, some of which were eroded. Biopsies confirmed infiltration by KS with nuclear positivity for HHV-8 in the immunohistochemistry. Colonoscopy and tomography showed no abnormalities. Chemotherapy was initiated with a good response [1] [2] [3] [4].

KS is a multifocal vascular neoplasm linked to HHV-8 infection and is considered one of the primary opportunistic diseases in HIV patients. While it primarily affects the skin, the gastrointestinal tract can be involved in 40% of cases. Clinical presentations may be asymptomatic or include abdominal pain, vomiting, gastrointestinal bleeding, or anemia. Endoscopically, it typically appears as submucosal nodular lesions with a vascular appearance and red-violet color, sometimes with an ulcerated surface. Biopsy is essential for diagnosis and to differentiate it from other conditions such as angiodysplasias, hemangiomas, neuroendocrine tumors, lymphomas or GIST. Treatment involves antiretrovirals, chemotherapy, and radiation therapy.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

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