Kaposi Sarcoma in Solid Organ Transplant Recipients: A challenging Case

Daniela Macedo,Pedro Miguel Garrido,José Guerra,Alice Santana,Isabel Fernandes,João Borges-Costa

doi:10.29021/spdv.77.3.1085

Abstract

Kaposi sarcoma is a low-grade vascular tumor, associated with human herpesvirus-8 infection. Solid organ transplant recipients have a much higher risk of this malignancy, with estimated incidence rates increased 84 to 500 times. The risk is even higher in some ethnic groups, already with a higher incidence of this disease. We report a case of a 37-year-old African male, a kidney transplant recipient, with a Kaposi sarcoma refractory to different treatment options. The present case puts in evidence the challenges associated with the management of this disease in this high-risk population and highlights the role of a multidisciplinary approach to achieve effective treatment, particularly in advanced and refractory forms.

Highlights

Kaposi sarcoma (KS) is a low-grade vascular tumor, with a complex pathogenesis, involving human herpes virus 8 (HHV-8) infection, cytokines and host-immune suppression.[1]
CASE REPORT A 37-year-old black male, born in a West African country, presented to our Dermatology Clinic with a six-month history of brown and violaceous nodules in his right leg. He had been submitted to kidney transplant two years before and his immunosuppressive therapy was mycophenolate mofetil 500 mg twice daily, rapamycin 3 mg once daily and prednisolone 5 mg once day
The patient had a transient improvement, but after 18 months he developed exudative skin lesions in his lower limbs and abdomen (Fig.s 1 and 2) and there was evidence of visceral disease, with gastric involvement confirmed by endoscopy and biopsy

Summary

Caso Clínico

Sarcoma de Kaposi em Receptores de Transplante de Órgão Sólido: Um Caso Desafiador. Os doentes com transplante de órgão sólido têm um elevado risco desta neoplasia, com taxas de incidência estimadas 84 a 500 vezes superiores às da população geral. We report a case of a 37-year-old African male, a kidney transplant recipient, with a Kaposi sarcoma refractory to different treatment options. The present case puts in evidence the challenges associated with the management of this disease in this high-risk population and highlights the role of a multidisciplinary approach to achieve effective treatment, in advanced and refractory forms. KEYWORDS – Immunocompromised Host; Organ Transplantation/adverse effects; Sarcoma, Kaposi/etiology; Transplant Recipients

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