Non-HIV Oral Kaposi Sarcoma: A Case Report and Review of the Literature

Sethia, Rishabh; Hari-Raj, Amrita; Koenigs, Maria; Özer, Enver

doi:10.1177/0145561319876917

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…The presence of a prominent vascular component associated with atypical cells in granulation tissue-like SC-SCC brings into the differential diagnosis the possibility of a malignant vascular neoplasm, mainly Kaposi sarcoma and angiosarcomas. Involvement of head and neck mucosal sites is rare in Kaposi sarcoma and is almost exclusively observed in HIV patients [ 17 – 19 ]. Immunohistochemical positivity for HHV8 is the key diagnostic feature.…”

Section: Discussionmentioning

confidence: 99%

Granulation tissue-like spindle cell (sarcomatoid) carcinoma of the head and neck: a deceptively bland-looking underdiagnosed malignancy

Franchi,

Agaimy

2024

Virchows Arch

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The diagnosis of head and neck spindle cell squamous carcinoma (SC-SCC) is often challenging. Lesions with a prominent inflammatory infiltrate and reactive vessels may have a granulation tissue-like appearance, therefore being difficult to distinguish from reactive lesions, like contact ulcers, post-intubation granulomas, inflammatory pseudotumors, or benign vascular lesions. In this study, we analyzed the clinicopathological features of a series of 17 head and neck SC-SCC with granulation tissue-like appearance. All patients, but two, were males, ranging in age between 57 and 80 years. The larynx was the most frequently affected site (n = 12), followed by the tongue (n = 4). One tumor was hypopharyngeal. Most consult cases were submitted with benign suggestion or because of unexpected recurrences of granulation tissue polyps. Histologically, all lesions consisted of an ulcerated polypoid proliferation of moderately to markedly atypical spindle cells, with a minor component of conventional invasive or in situ squamous carcinoma. At least one cytokeratin cocktail was positive in 13 cases. The staining was limited to a few neoplastic cells in most cases. Positivity for p63, p40, and cytokeratins 5/6 was detected only in the conventional squamous cell carcinoma component, when present. ALK1 was negative in all cases. Sixteen cases were tested for p53 and all showed aberrant expression (12 diffusely positive and 4 of null-phenotype). The diagnosis of granulation tissue-like SC-SCC is challenging due to the close clinical and histological overlap with several benign conditions. Since the expression of epithelial markers is limited, the use of an immunohistochemical panel including p53 is recommended.

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Section: Discussionmentioning

confidence: 99%

Granulation tissue-like spindle cell (sarcomatoid) carcinoma of the head and neck: a deceptively bland-looking underdiagnosed malignancy

Franchi,

Agaimy

2024

Virchows Arch

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“…In the other clinical forms of KS, manifestations in the mouth are extremely rare, ( 18 ). Case reports have highlighted oral Kaposi lesions in the context of patients effectively treated for their HIV infection and in patients without HIV but with unprotected homosexual behavior ( 17 - 18 ). Moreover, KSHV infection has a very high prevalence in those patients.…”

Section: Discussionmentioning

confidence: 99%

Oral Kaposi Sarcoma in two patients living with HIV despite sustained viral suppression: New clues

Messeca¹,

Balanger²,

Duval³

et al. 2022

J Clin Exp Dent

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Kaposi sarcoma (KS) etiologically linked to Kaposi sarcoma-associated herpesvirus (KSHV) is the most common HIV associated cancer despite the generalization of antiretroviral therapy. Head, neck, and especially oral cavity are common and specific sites for lesions. Those oral lesions contain a high viral load of KSHV virus and are one of the signs of disease severity. The development of KS in HIV-infected patients is classically described in case of low CD4 count, but recently reported cases revealed oral KS despite a robust CD4 count, such observations being possibly linked to interactions between periodontal germs and the oncogenic KSHV virus. We present two cases of KS location on the oral mucosa in HIV patients with gingival inflammation despite efficient antiretroviral treatment and immune restoration. Those cases suggest that the diagnosis of oral KS lesions should be considered by oral surgeons, dermatologists, and infectious specialists, when managing any suspicious lesion in an HIV patient, even with undetectable HIV viral loads, or in a seronegative patient with unprotected sexual activity. Key words: Kaposi Sarcoma, KSHV, HIV infection, CD4 count, oral lesion, oral cancer, periodontal pathogens.

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