Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Jan 7;16(1):e51782.
doi: 10.7759/cureus.51782. eCollection 2024 Jan.

Re-irradiation of a Classic Kaposi's Sarcoma Using Volumetric Modulated Arc Therapy

Zhe Chen  1 , Steven Daveluy  2 , Geoff Baran  1 , Michael Joiner  1 , Steven Miller  1
Affiliations
Case Reports

Re-irradiation of a Classic Kaposi's Sarcoma Using Volumetric Modulated Arc Therapy

Zhe Chen et al. Cureus. .

Abstract

A black male in his 60s diagnosed with classic Kaposi's sarcoma presented with multiple cutaneous nodules and edema of the right foot and lower leg. He was initially treated with alitretinoin 1% topical treatment. However, 16 months after treatment with the alitretinoin, the skin lesions progressed, and he subsequently underwent a course of radiation therapy to a total dose of 2000 centigrays (cGy) in five fractions to his right foot and lower extremities. Approximately 1.5 years after the radiation therapy was completed, multiple new lesions developed on the right foot and distal lower leg. He then underwent a course of re-irradiation to this area using volumetric modulated arc therapy (VMAT) to a total dose of 3300 cGy in 11 fractions. At a four-week follow-up visit, the skin lesions had completely resolved; however, the patient experienced mild edema and tenderness of the right foot and lower leg. Although long-term outcomes need to be followed, re-irradiation showed positive short-term outcomes for classic Kaposi's sarcoma.

Keywords: clinical dermatology; kaposi sarcoma hiv negative; radiation and clinical oncology; re-irradiation; volumetric-modulated arc therapy.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. 200X magnification. Hematoxylin and eosin stains show ill-defined, interweaving vascular channels. Immunohistochemistry showed that the lesional cells were positive for HHV and endothelial markers CD34 and D2-40.
HHV: Human herpes virus.
Figure 2
Figure 2. Right medial foot lesion
Figure 3
Figure 3. Right toe lesion
Figure 4
Figure 4. Initial radiation therapy treatment
Figure 5
Figure 5. Pre-treatment images of the right foot; note the areas of discoloration involving the medial foot
Figure 6
Figure 6. Radiation dose color wash of the right lower leg planned using volumetric modulated arc therapy (VMAT)
See this image and copyright information in PMC

References

    1. Kaposi sarcoma. Cesarman E, Damania B, Krown SE, Martin J, Bower M, Whitby D. Nat Rev Dis Primers. 2019;5:9. - PMC - PubMed
    1. Kaposi sarcoma. [ Sep; 2023 ]. 2023. http://www.nccn.org/professionals/physician_gls/pdf/kaposi.pdf http://www.nccn.org/professionals/physician_gls/pdf/kaposi.pdf
    1. Radiation therapy in the treatment of HIV-related Kaposi's sarcoma. Donato V, Guarnaccia R, Dognini J, de Pascalis G, Caruso C, Bellagamba R, Morrone A. http://ar.iiarjournals.org/content/anticanres/33/5/2153.full.pdf. Anticancer Res. 2013;33:2153–2157. - PubMed
    1. Palliative treatment of Kaposi sarcoma with radiotherapy: a single center experience. Inan GA, Aral IP, Arslan SA, Tezcan Y. Radiat Oncol J. 2021;39:41–47. - PMC - PubMed
    1. Radiotherapy of classic and human immunodeficiency virus-related Kaposi's sarcoma: results in 1482 lesions. Caccialanza M, Marca S, Piccinno R, Eulisse G. J Eur Acad Dermatol Venereol. 2008;22:297–302. - PubMed

Publication types

LinkOut - more resources