Aggressive tumors in a patient with HIV-induced immunosuppression

Abstract

A 59-year-old man with a 2-year history of acquired immunodeficiency syndrome, who was adherent to highlyactive antiretroviral therapy, developed tumors in his right inguinal region over one month. He reported loss of appetite, local pain, and fever, soon followed by tumor onset. Physical examination revealed an erythematousto-violaceus plaque extending from the right inguinal region to the inner thigh with underlying multiple friable violaceus tumors and adherent lymph nodes (Fig 1). The CD4 count was 138 cells/mm 3 with undetectable viral load. Skin biopsy, histopathological exam (Fig 2), and immunostainings were performed, including epithelial membrane antigen (EMA), anaplastic lymphoma kinase (ALK) and CD markers (Fig 3). Imaging exams revealed no systemic involvement.