Genital Kaposi sarcoma in a HIV and syphilis co-infected patient: case presentation

Abstract

BackgroundKaposi sarcoma, as an epidemiological factor, is associated with acquired immunodeficiency syndrome (AIDS) and it is related to human herpes virus (HHV-8), as well as a higher prevalence in males and non-genital involvement. Vulvar localization is quite infrequent; therefore it may be considered in the differential diagnosis of genital lesions, especially in HIV patients.Case presentationWe describe the atypical presentation of a female HIV patient with multiple comorbidities, with the clinical manifestation of Kaposi sarcoma (KS) in a vulvar region that was initially diagnosed as a syphilitic gumma. The patient underwent a biopsy of the lesion, and histopathology revealed a Kaposi sarcoma.DiscussionThis case reinforces that the pathogenesis of Kaposi sarcoma is still unclear and that probably multiple factors, regarding both the virus and the patient characteristics may lead to carcinogenesis. Conclusion: It is imperative to seek more excellent knowledge about this disease, to facilitate the diagnosis, to warrant the appropriate treatment and to improve the prognosis of the patient, especially the genital lesions.

Imaging of Kaposi sarcoma

“…In men, within the genitourinary tract, KS is more commonly seen on the penis. In women, genital tract involvement is not commonly seen [45]. Lesions along the genital tract such as on the urethral meatus can sometimes lead to outlet obstruction and urinary retention [46].…”

Diffuse Kaposi sarcoma with oral involvement in a person diagnosed with human immunodeficiency virus/acquired immune deficiency syndrome: A case report

“…This case reinforces the fact that multiple factors regarding the virus and the patient’s immune system may lead to carcinogenesis. 6 Our patient presented maculopapular lesions on the upper and lower limbs, trunk, back, both feet soles, and on the oral mucosa. Clinically, there are four types of KS based on its biological behavior and morphologic features: nodular, florid, infiltrative, and lymphadenopathic.…”

“…The etiopathogenesis of KS is known to include exposure to infectious agents, especially HHV-8, which is found in more than 90% of KS lesions in individuals with AIDS. 5 , 6 A consistent gradual decline in KS incidence has occurred among people living with HIV since the introduction of highly active antiretroviral therapy. 7 On the other hand, syphilis is known to be the “great imitator” and is difficult to diagnose due to its variable clinical presentations, especially in HIV-infected individuals.…”