Genital Kaposi sarcoma in a HIV and syphilis co-infected patient: case presentation

Helena Lucia Barroso Dos Reis,Carolina Galvão,Marize Freitas Santos Neves,Philippe Godefroy,João Victor Jacomele Caldas,Neide Aparecida Tosato Boldrini,Dennis De Carvalho Ferreira

doi:10.1186/s12879-019-4714-8

Abstract

BackgroundKaposi sarcoma, as an epidemiological factor, is associated with acquired immunodeficiency syndrome (AIDS) and it is related to human herpes virus (HHV-8), as well as a higher prevalence in males and non-genital involvement. Vulvar localization is quite infrequent; therefore it may be considered in the differential diagnosis of genital lesions, especially in HIV patients.Case presentationWe describe the atypical presentation of a female HIV patient with multiple comorbidities, with the clinical manifestation of Kaposi sarcoma (KS) in a vulvar region that was initially diagnosed as a syphilitic gumma. The patient underwent a biopsy of the lesion, and histopathology revealed a Kaposi sarcoma.DiscussionThis case reinforces that the pathogenesis of Kaposi sarcoma is still unclear and that probably multiple factors, regarding both the virus and the patient characteristics may lead to carcinogenesis. Conclusion: It is imperative to seek more excellent knowledge about this disease, to facilitate the diagnosis, to warrant the appropriate treatment and to improve the prognosis of the patient, especially the genital lesions.

Highlights

Kaposi sarcoma, as an epidemiological factor, is associated with acquired immunodeficiency syndrome (AIDS) and it is related to human herpes virus (HHV-8), as well as a higher prevalence in males and non-genital involvement
After the 17th day of penicillin, a biopsy of a persistent nodular lesion was performed in the external surface of the right labium majus (Fig. 1b), whose microscopic analysis of the obtained material showed proliferation of endothelial cells and the presence of fusiform cells, as well as vascular neoformation and extravasated red blood cells, confirming the diagnosis of Kaposi’s sarcoma
The development of Kaposi sarcoma (KS) is related to Human immunodeficiency virus (HIV) infection and, especially, to opportunistic infections that may lead to the inflammatory response to such diseases [6]

Summary

Discussion

This case reinforces that the pathogenesis of Kaposi sarcoma is still unclear and that probably multiple factors, regarding both the virus and the patient characteristics may lead to carcinogenesis. Conclusion: It is imperative to seek more excellent knowledge about this disease, to facilitate the diagnosis, to warrant the appropriate treatment and to improve the prognosis of the patient, especially the genital lesions

Background

Findings

Discussion and conclusions