Bilateral Tonsillar and Esophageal Kaposi Sarcoma in an HIV-Negative Patient

Abstract

Tonsillar involvement in Kaposi sarcoma is extremely rare, as only a few such cases have been reported; all but 1 of these previously reported cases occurred in patients with human immunodeficiency virus (HIV) infection. We describe what to the best of our knowledge is the first reported case of concurrent bilateral tonsillar and esophageal Kaposi sarcoma in an HIV-negative patient. A 68-year-old man presented with sore throat and dysphagia. Clinical examination revealed the presence of bilateral and asymmetrical tonsillar masses, as well as generalized lymphadenopathy in the cervical chain. The masses were resected, and findings on histopathologic analysis were consistent with Kaposi sarcoma. In addition, human herpesvirus 8 was demonstrated on a tonsil specimen by polymerase chain reaction, and microinvasive squamous cell carcinoma was also detected. Later, another Kaposi sarcoma lesion was detected in the lower third of the esophagus. We recommend that clinicians not discount the possibility of oral classic Kaposi sarcoma in the workup of an immunocompetent patient with oral vascular lesions.

Nodular lesion on the posterior dorsal surface of the tongue

“…As previously mentioned, considering that AIDSassociated KS is one of the most frequent clinical presentations compared with other KS types, corresponding serologic tests should be performed in all KS cases to confirm or rule out such an association. 24 The therapeutic approach for HIV-negative KS can be surgery, radiotherapy, chemotherapy, and interferon-a. [14][15][16][23][24][25][26][27][28][29][30] For KS associated with HIV, treatment with highly active antiretroviral therapy is the first modality considered.…”

Tonsillar Kaposi sarcoma in a renal transplant patient

“…5 Tonsillar KS in HIV-negative patients is very rare with only a few reported cases. [6][7][8][9] Clinicians should be Alteration of the immunosuppressive regimen to include sirolimus has been shown to improve outcomes, likely due to the antitumoral effects of sirolimus. 12,13 Extensive or refractory cases may still require additional chemotherapy.…”

“…In the post‐transplant setting, 90% of KS cases involve the skin and/or mucosa, while 25%‐30% of renal transplant recipients show visceral organ involvement 5 . Tonsillar KS in HIV‐negative patients is very rare with only a few reported cases 6‐9 . Clinicians should be aware of dysphagia and tonsillar enlargement as a rare presentation of KS in post‐transplant patients, particularly during the first 2 years when most cases occur.…”

Oral Manifestation of Kaposi's Sarcoma in Patient with AIDS: Case Report

“…HAART may help to reverse the injury, although, sometimes, new manifestations may arise, even using the therapy, there is the possibility of failure of therapy, or resistance to the drugs administered and even the abandonment of treatment and even the worsening of the disease. The encapsulation of anthracycline liposomes constitutes a considerable advance in SK chemotherapy [1,5,6,12,17,18,23].…”

“…Both, Daunoxome® 40 mg/m 2 every two weeks, and Caelyx® 20 mg/m 2 every three weeks, showed good results in antitumor activity. The toxicity profile is better than other anthracyclines, without reported cardiotoxicity, even with high cumulative doses, but they present considerable myelosuppression, and occasional vomiting, and local treatments can be justified to improve quality of life, aesthetics, phonation, swallowing, Oral hygiene, restoration of masticatory function, and pain relief and hemorrhage [1,5,6,18].…”