Isolated Kaposi Sarcoma in two HIV negative patients

Abstract

Background: Kaposi sarcoma (KS) is a neoplasm of the endothelial cells. It often manifests with multiple vascular nodules on the skin and other organs. It is a systemic, malignant and multifactorial disease and has a variable course. There are four types: classic, endemic, iatrogenic and HIV-associated. The primary presentation on the penis and face is uncommon and is mainly observed in HIV-positive patients. Multiple treatment modalities are used including surgery, cryotherapy, electrosurgery, laser and radiation therapy.

Main observation: The authors present two cases of isolated Kaposi sarcoma in HIV negative, human herpes virus 8 (HHV-8) positive non immunocompromised patients. One case with facial KS and the other one with penile KS. Both were treated surgically with no recurrence in the following 6 months of the follow up period.

Conclusions: Kaposi sarcoma is rare in HIV negative patients and is associated with HHV-8 infection. Lesions are usually solitary and can be treated surgically. It should be included in the differential diagnoses of penile and facial lesions that are clinically suspecious and resistent to therapy.

Keywords: HIV; Kaposi sarcoma; face; nodule; penis; tumor.

Figure 1

Violaceous nodule on glans penis.

Figure 2

A) Blood filled slits like spaces, spindle shaped cells with prominent pleomorphism, extravasated RBCs and cellular infitrate made of plasma cells and lymphocytes (hematoxylin and eosin X200). B) Positive immune reactivity for CD 34 in endothelial cells and neoplastic cells (immunoperoxidase X200). C) Slit like spaces and proliferating pleomorphic spindle shaped cells (hematoxylin and eosin X100). D) Positive immune reactivity for CD 34 in endothelial cells and neoplastic cells (immunoperoxidase X100).