Gastric Kaposi sarcoma as an endoscopic finding in an HIV patient

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.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Guimarães DF, Nobre-e-Souza MA, Souza MHLP.. Gastric Kaposi sarcoma: A difficult endoscopic diagnosis. Dig Endosc 2017; 29 (2): 229-229
• 2 Carmo J, Marques SC, Bispo M, Pinto D, Chagas C.. Clinical and endoscopic features of gastrointestinal Kaposi sarcoma: A single-center Portuguese experience over the last decade. GE Port J Gastroenterol 2017; 24 (5): 219-26
• 3 Tejedor-Tejada J, Núñez Rodríguez H, Madrigal Rubiales B, González-González D.. Kaposi sarcoma involving gastrointestinal tract in VIH. Dig Liver Dis 2020; 52 (2): 238-9

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025