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Kaposi sarcoma

Kaposi's sarcoma; HIV - Kaposi; AIDS - Kaposi

Kaposi sarcoma (KS) is a cancerous tumor of the connective tissue.

Causes

KS is the result of infection with a herpesvirus known as Kaposi sarcoma-associated herpesvirus (KSHV), or human herpesvirus 8 (HHV8). It is in the same family as the Epstein-Barr virus, which causes mononucleosis.

KSHV is transmitted mainly through saliva. It can also be spread through sexual contact, blood transfusion, or transplants. After it enters the body, the virus can infect different kinds of cells, especially cells that line blood vessels and lymphatic vessels. Like all herpesviruses, KSHV remains in your body for the rest of your life. If your immune system becomes weakened in the future, this virus may have the chance to reactivate, causing symptoms.

There are four types of KS based on the groups of people who are infected:

  • Classic KS: Mainly affects older men of Eastern European, Middle Eastern, and Mediterranean descent. The disease usually develops slowly.
  • Epidemic (AIDS-related) KS: Occurs most often in people who have HIV infection and have developed AIDS.
  • Endemic (African) KS: Mainly affects people of all ages in Africa.
  • Immunosuppression-associated, or transplantation-associated, KS: Occurs in people who have had an organ transplant and are medicines that suppress their immune system.

Symptoms

The tumors (lesions) most often appear as bluish-red or purple bumps on the skin. They are reddish-purple because they are rich in blood vessels.

The lesions may first appear on any part of the body. They also can appear inside the body. Lesions inside the body may bleed. Lesions in the lungs can cause bloody sputum or shortness of breath.

Exams and Tests

The health care provider will perform a physical exam, focusing on the lesions.

The following tests may be performed to diagnose KS:

Treatment

How KS is treated depends on:

Treatments include:

  • Antiviral therapy against HIV, since there is no specific therapy for HHV-8
  • Combination chemotherapy
  • Freezing the lesions
  • Radiation therapy

Lesions may return after treatment.

Outlook (Prognosis)

Treating KS does not improve the chances of survival from HIV/AIDS itself. The outlook depends on the person's immune status and how much of the HIV virus is in their blood (viral load). If the HIV is controlled with medicine the lesions will often shrink away on their own.

Possible Complications

Complications can include:

  • Cough (possibly bloody) and shortness of breath if the disease is in the lungs
  • Leg swelling that may be painful or cause infections if the disease is in the lymph nodes of the legs

The tumors can return even after treatment. KS can be deadly for a person with AIDS.

An aggressive form of endemic KS can spread quickly to the bones. Another form found in African children does not affect the skin. Instead, it spreads through the lymph nodes and vital organs, and can quickly become deadly.

Prevention

Safer sexual practices can prevent HIV infection. This prevents HIV/AIDS and its complications, including KS.

KS almost never occurs in people with HIV/AIDS whose disease is well controlled.

References

Habif TP. Vascular tumors and malformations. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 23.

Kaye KM. Kaposi's sarcoma-associated herpesvirus (human herpesvirus 8). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 143.

National Cancer Institute website. Kaposi sarcoma treatment (PDQ) - health professional version. www.cancer.gov/types/soft-tissue-sarcoma/hp/kaposi-treatment-pdq. Updated July 27, 2018. Accessed December 18, 2018.

  • Kaposi sarcoma - lesion on the foot

    Kaposi sarcoma - lesion on the foot - illustration

    Kaposi sarcoma lesion on the foot. This once-rare malignancy of the blood vessels is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. The malignancy results in purplish grape-like lesions in the skin, gastrointestinal tract and other organs.

    Kaposi sarcoma - lesion on the foot

    illustration

  • Kaposi sarcoma on the back

    Kaposi sarcoma on the back - illustration

    Kaposi sarcoma was once a rare malignancy of the blood vessels but is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. Recent research has suggested that this malignancy may be caused by a newly discovered herpes virus. The malignancy results in purplish, grape-like lesions in the skin, gastrointestinal tract, and other organs.

    Kaposi sarcoma on the back

    illustration

  • Kaposi sarcoma - close-up

    Kaposi sarcoma - close-up - illustration

    Kaposi sarcoma was once a rare malignancy of the blood vessels but is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. The malignancy results most frequently in purplish to reddish-purple flat or grape-like lesions in the skin, gastrointestinal tract, and other organs.

    Kaposi sarcoma - close-up

    illustration

  • Kaposi sarcoma on the thigh

    Kaposi sarcoma on the thigh - illustration

    Kaposi sarcoma, seen here on the thigh, was once a rare malignancy of the blood vessels, but is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. The malignancy results in purplish to reddish-purple grape-like lesions in the skin, gastrointestinal tract, and other organs.

    Kaposi sarcoma on the thigh

    illustration

  • Kaposi sarcoma - perianal

    Kaposi sarcoma - perianal - illustration

    Kaposi sarcoma usually occurs in male homosexuals with AIDS. These lesions can appear anywhere on the body as purple, elevated growths. This sarcoma is located near the anus (perianal).

    Kaposi sarcoma - perianal

    illustration

  • Kaposi sarcoma on foot

    Kaposi sarcoma on foot - illustration

    Kaposi sarcoma is a malignant tumor of the connective tissue.

    Kaposi sarcoma on foot

    illustration

    • Kaposi sarcoma - lesion on the foot

      Kaposi sarcoma - lesion on the foot - illustration

      Kaposi sarcoma lesion on the foot. This once-rare malignancy of the blood vessels is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. The malignancy results in purplish grape-like lesions in the skin, gastrointestinal tract and other organs.

      Kaposi sarcoma - lesion on the foot

      illustration

    • Kaposi sarcoma on the back

      Kaposi sarcoma on the back - illustration

      Kaposi sarcoma was once a rare malignancy of the blood vessels but is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. Recent research has suggested that this malignancy may be caused by a newly discovered herpes virus. The malignancy results in purplish, grape-like lesions in the skin, gastrointestinal tract, and other organs.

      Kaposi sarcoma on the back

      illustration

    • Kaposi sarcoma - close-up

      Kaposi sarcoma - close-up - illustration

      Kaposi sarcoma was once a rare malignancy of the blood vessels but is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. The malignancy results most frequently in purplish to reddish-purple flat or grape-like lesions in the skin, gastrointestinal tract, and other organs.

      Kaposi sarcoma - close-up

      illustration

    • Kaposi sarcoma on the thigh

      Kaposi sarcoma on the thigh - illustration

      Kaposi sarcoma, seen here on the thigh, was once a rare malignancy of the blood vessels, but is now associated with AIDS. It is more frequently associated with AIDS in homosexual men than AIDS in IV drug users. The malignancy results in purplish to reddish-purple grape-like lesions in the skin, gastrointestinal tract, and other organs.

      Kaposi sarcoma on the thigh

      illustration

    • Kaposi sarcoma - perianal

      Kaposi sarcoma - perianal - illustration

      Kaposi sarcoma usually occurs in male homosexuals with AIDS. These lesions can appear anywhere on the body as purple, elevated growths. This sarcoma is located near the anus (perianal).

      Kaposi sarcoma - perianal

      illustration

    • Kaposi sarcoma on foot

      Kaposi sarcoma on foot - illustration

      Kaposi sarcoma is a malignant tumor of the connective tissue.

      Kaposi sarcoma on foot

      illustration

     

    Review Date: 12/1/2018

    Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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