Case report: A 33-year-old man recently diagnosed with HIV infection with severe immunosuppression
(CD4: 35 cells per microlitre) who presented dysphagia for solids. Gastroscopy revealed
a fibrinated ulcer in the hypopharynx and multiple erythematous pseudonodules were
incidentally observed in the fundus and gastric body, that studied and compatible
with gastric Kaposi sarcoma [1]
[2]
[3].
Discussion: Kaposi sarcoma (KS) is a low-grade angioproliferative neoplasm associated with infection
by the human herpes virus 8 (HHV-8), and is more frequent in HIV patients. It constitutes
60% of tumors in patients with HIV and is the most common abdominal neoplasm in them.
Around 50% of gastric KS are diagnosed at the AIDS stage and in coexistence of cutaneous
KS. KS can occur in any digestive location, being more frequent in the gastric area,
with hemorrhagic or purpuric pseudonodular lesions. They are usually asymptomatic,
but can cause constitutional syndrome, abdominal pain, vomiting, malabsorption or
gastrointestinal bleeding. Diagnosis is based on endoscopic biopsies; if they are
not conclusive, vascular lineage markers and HHV-8 will be detected in the tissue
by immunohistochemistry. Differential diagnosis should be made with non-Hodgkin lymphomas
or gastrointestinal stromal tumors. Treatment is based on antiretroviral therapy and
systemic chemotherapy, as well as radiotherapy and other local treatments in selected
cases.
