Intralesional Interferon Alpha-2b Therapy for Adnexal Kaposi Sarcoma

Abstract

To describe a case of adnexal Kaposi's sarcoma successfully treated with intralesional interferon alpha 2b injections. Case Report. A 31 year old black Haitian male presents with severe nodular induration and erythema of both eyelids with hemorrhagic infiltration of the bulbar and palpebral conjunctivae, advanced on the right. Clinical, histological, and immunohistochemical examination yielded the diagnosis of Kaposi's sarcoma. The patient was subsequently diagnosed with AIDS, started on highly active anti-retroviral therapy (HAART) and systemic doxorubicin, and initially received topical 3 million IU per mL of interferon alpha-2b eyedrops (Intron-A(R), Schering Corporation, Kenilworth, NJ) every 6 hours to the right eye for 9 weeks. This systemic therapy resulted in minimal clinical response with a CD4 count increase from 12 to 61 cells per microliter. Progressive entropion and corneal compromise on the right prompted a trial of intralesional injections of interferon alpha-2b. Over a 4 week period, 3 injections (3 million IU in 0.5mL, 1.5 million IU in 0.5mL, and 1.5 million IU in 0.5mL) were given. This resulted in a dramatic reduction in tumor burden and lid edema, an improvement in lid position, and corneal healing. Ocular adnexal and conjunctival Kaposi's sarcoma was successfully treated with 3 adjuvant intralesional interferon alpha-2b injections leading to a dramatic decrease in tumor mass.