Visceral Kaposi's Sarcoma Related to Human Herpesvirus-8 in Liver Transplant Recipient: Case Report and Literature Review

Abstract

Background. Kaposi's sarcoma (KS) in transplant recipients is about 400 to 500 times rate in the general population. It is strongly associated to Human herpesvirus-8 (HHV-8) infection which has been found in 95% of KS lesions. The optimal approach to managing posttransplantation KS is to reduce or discontinue immunosuppressive therapy but this strategy carries a risk of the acute rejection of the graft. Recently, the use of an mTOR inhibitor has added new opportunities for KS treatment and prevention. Case Report. We report a case of 24 years-old Turkish woman with visceral HHV-8-associated Kaposi's sarcoma after orthotopic liver transplantation. Conclusion. Posttransplantation KS is considered an experimental model of virus induced tumor suggesting the usefulness of HHV-8 screening in transplant recipient and donor. Therapeutic approaches are complex and require a multidisciplinary team.

Figure 1

Computed tomography showing multiple pulmonary nodules (a) and retroperitoneal lymph nodes (b).

Figure 2

Microscopic findings of small bowel specimen showing atypical spindle cells with extravasated erythrocytes and capillaries (HES ×100).

Figure 3

Immunohistochemical analysis showing the positivity for CD31 and CD34 (a) and the strong immunoreactivity for HHV-8 in the nuclei (b).