Kaposi Sarcoma In Children Research Articles

Kaposi's sarcoma in childhood: An analysis of 100 cases from Uganda and relationship to HIV infection

We report 100 cases of Kaposi's sarcoma (KS) in children under 15 years of age treated at the Uganda Cancer Institute in the 6-year period 1989–1994. The incidence of childhood KS has risen more than 40-fold in the era of AIDS, and 78% of 63 cases tested were seropositive for HIV-I. There were 63 boys and 37 girls. The median age was 4 years and the median age of onset was 33 months. Tumour distribution was lymphadenopathic and muco-cutaneous, with 2 major patterns: pattern I, oro-facial dominant (79%); and pattern II, inguinal-genital dominant (13%). A newly described herpes-like virus is implicated as the cause of KS (KSHV), and DNA sequences of this virus were present in all of 8 childhood cases tested. If KSHV is a direct cause of KS, this tumour distribution in children suggests mucosal routes of virus entry, possibly during birth or breast feeding. The dramatic increase of childhood KS implies that the prevalence of causative factors is rising in Uganda. © 1996 Wiley-Liss, Inc.

Influence of HIV Epidemic on the Incidence of Kaposi??s Sarcoma in Zambian Children

Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (KS) is well documented in adults. However, very little information is available about KS in the pediatric age group. A retrospectively study was undertaken at the University Teaching Hospital (UTH), Lusaka, Zambia, to define the incidence and clinical profile of KS in Zambian children over the last 13 years and to determine the influence, if any, of the current human immunodeficiency virus (HIV) epidemic on the pattern of pediatric KS. All the histopathological records from 1980 to 1992 were reviewed and all cases of KS along with the total number of malignancies, both in children and adults, were analyzed. Along with this, 17 of 23 case files of pediatric KS patients treated at the UTH since 1984 were retrieved and clinical details recorded. Of a total of 915 cases of KS, 85 (9.25%) were in children < 14 years of age. The age ranged from 7 months to 14 years, with an average of 5.62 years; the male/female ratio was 1.76:1. A significant increase in the incidence of pediatric KS has been recorded since 1987 (p < 0.001). This coincides with the advent of the HIV epidemic in the country. The disease was aggressive and fulminant in pediatric patients. More than 80% HIV seropositivity was detected. Children with blood transfusion-related HIV infection had cutaneous or lymphocutaneous disease, indicating that the mode of acquisition of HIV infection may influence the clinical appearance of KS. Thus, HIV-associated KS in children is becoming a common entity in Zambia. An urgent prospective epidemiologic study is needed to address this problem in HIV-affected regions.

Transplant-related Kaposi sarcoma in children

Transplant-related Kaposi sarcoma in children

AIDS-associated Kaposi's sarcoma in Romanian children

Kaposi's sarcoma (KS) is commonly associated with the acquired immunodeficiency syndrome (AIDS) in adults. Little is known regarding its occurrence in children. Our purpose was to report the clinical and epidemiologic characteristics of KS in three Romanian children with AIDS and to compare them with previously reported AIDS-associated KS in children. This was a clinicopathologic study and computer-based literature review. All three Romanian children had skin involvement; two had involvement of lymph nodes and internal organs. All had acquired human immunodeficiency virus (HIV) infection postnatally. Including these children, 33 cases of AIDS-associated KS in children have been reported. Thirteen of 30 evaluable patients had acquired HIV infection postnatally; nine of these children (69%) had cutaneous involvement by KS. A perinatal route of transmission was present in the remaining 17 cases; only two of these children (12%) with KS had cutaneous involvement. No case was noted in which intravenous drug use was the sole parental HIV risk factor. The data support the contention that KS is caused by a second infectious agent prevalent only in certain HIV-infected populations. Children of parents in high-risk groups for KS and children who acquire HIV via contaminated blood or blood products are at highest risk for KS. The route of acquisition of HIV infection may also be associated with different clinical manifestations of KS in children.

Geopathology of endemic pediatric lymph node Kaposi's sarcoma in Western Kenya.

We conducted an epidemiological and histological analysis of the endemic lymph node-type Kaposi's sarcoma (KS) in African children (under 16 years old) in Western Kenya in order to determine the ethno-geographical distribution of the disease and to clarify its histological features and histogenesis during the 12-year period between 1979 to 1990. The age distribution of all endemic type KS in Western Kenya showed two age peaks; one in early childhood and the other in middle to advanced age. Most endemic KS in children initially occurred in the lymph nodes, while that of people of middle to advanced age showed a primary lesion in the skin. The male to female ratio of the endemic KS was 3.1 to 1 (in all pediatric types), 3.4 to 1 (in the pediatric lymph node-type) and 10.8 to 1 (in all adult types). A high incidence of the lymph node-type KS in children was observed in the Luo group ethnically and in Nyanza Province around Lake Victoria geographically. The lymph node-type KS originated at the paracortical areas and gradually grew along the reticulin network originating from the trabeculae. The lesion of KS histologically consisted of several types of cells, especially spindle-shaped cells, macrophage-like cells and immature endothelial cell-like cells and was accompanied by almost normal small blood vessels, lymphatic vessels and postcapillary venules. No abnormal mitoses were observed in any of the cells. There were no primary necroses due to tumor proliferation and also no extracapsular invasions. Immunohistochemically, spindle-shaped cells, immature endothelial cell-like cells and mature endothelial cells were positive for Vimentin, but only mature endothelial cells were positive for Factor-VIIIRa and UEA-1. Macrophage-like cells were positive for Factor-XIIIRa. These findings suggested that : 1) there are certain differences in the etiological co-factors of KS between the endemic lymph node-type KS in children and the endemic cutaneous type KS in adults, 2) KS cells originate from pluripotent mesenchymal cells and 3) KS might not be a malignant tumor, but rather a benign neoplasm, tumor-like lesion or reactive hyperplasia.

Childhood Kaposi's sarcoma: clinical features and therapy.

Twelve cases of childhood Kaposi's sarcoma seen at the Uganda Cancer Institute over the last 7 years are reported. The disease presents mainly as generalized lymphadenopathy, with sparsely and anomalously distributed cutaneous nodules, and has a higher proportion of females with the disease than in the adult form. The histology is usually of mixed cell type. If not treated, childhood Kaposi's sarcoma runs a fulminating course, but disease control with chemotherapy is associated with prolonged survival.