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A digital manual for the early diagnosis of oral neoplasia

Kaposi sarcoma  Search in Medline for Kaposi sarcoma



Kaposi sarcoma (KS) is a mesenchymal tumour involving the blood and lymphatic endothelium. It is a locally aggressive tumour typically involving the skin, but may also involve mucosal sites and lymph nodes. Metastasis is rare. Four different clinical types are described: classic indolent form seen in elderly men of Mediteranean or East European descent; endemic type seen in middle-aged men and children in Equatorial Africa; iatrogenic type seen in immunosuppressed post transplant patients, and the most aggressive, AIDS-associated type, seen in HIV-infected individuals van der Waal ILJ, Knuutila S (2005).  Kaposi Sarcoma. In: Barnes L, Eveson,JW, Reichart,P, Sidransky,D eds.  Pathology & Genetics. Head and Neck Tumours, Lyon, IARC Press, 193-194..
The disease is the result of a complex interplay of human herpes virus 8 infection, genetic and environmental factors Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS (1994). Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma. Science 266: 1865-1869..
Clinically, the disease appears as purplish, reddish-blue or brown macules, plaques or nodules.

Differential diagnosis:



Treatment:

Localised lesions are treated by local excision, cryotherapy or radiotherapy Ficarra G, Berson AM, Silverman S Jr, Quivey JM, Lozada-Nur F, Sooy DD, Migliorati CA (1988). Kaposi's sarcoma of the oral cavity: a study of 134 patients with a review of the pathogenesis, epidemiology, clinical aspects, and treatment. Oral Surg Oral Med Oral Pathol 66: 543-550.. More disseminated lesions are treated by immunotherapy using interferon alfa, or chemotherapy with adriamycin, taxol or vinblastin Morris AK, Valley AW (1996). Overview of the management of AIDS-related Kaposi's sarcoma. Ann Pharmacother. 1996 Oct;30(10):1150-63.Aversa SM, Cattelan AM, Salvagno L, Crivellari G, Banna G, Trevenzoli M, Chiarion-Sileni V, Monfardini S. (2005). Treatments of AIDS-related Kaposi's sarcoma. Crit Rev Oncol Hematol. 2005 Mar;53(3):253-65.. In AIDS-associated Kaposi sarcoma, highly active antiretroviral therapy (HAART) is indicated.


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Figure 1: Kaposi sarcoma of the palate.
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