Kaposi’s sarcoma management from a plastic surgery perspective

Abstract

Aim of the study Kaposi's sarcoma (KS) is a low-grade angioproliferative tumor arising from endothelial cells and associated with Human Herpes Virus 8 infection. Although there are considerable number of patients referred for surgical excision, the plastic surgery literature on KS is exceptionally scarce. In this study, it was aimed to emphasize the differences in the management of Kaposi's Sarcoma and help to understand the importance of a multidisciplinary approach, accordingly the sake of choosing the ideal treatment method for each lesion. Materials and methods Thirty patients who were operated with the diagnosis of KS between March 2015 and January 2020 were included. Preoperative HIV tests and detailed whole-body examinations of the patients were performed. As a surgical method, for lesions with sizes ranging from 0.5 * 1 cm to 2 * 3 cm, excisions were made over the deep skin fascia by placing a margin between 0.5-1 cm, considering the anatomical location and elasticity of the skin. Results Primary repair was performed in 23 patients (40 lesions) and 12 lesions of 8 patients were repaired with a skin graft. In four patients the repair was performed with local skin flaps. In a patient with a lesion on the finger, the defect that occurred after the excision of the lesion was repaired with a pedicled regional flap. Conclusions One-stage surgical excision of the lesions provides remarkable advantages, compared to the therapies such as radiotherapy, laser, or chemotherapy which require several administrations.