Oral Kaposi's Sarcoma Research Articles

Survival Following Diagnosis of HIV-Associated Kaposi Sarcoma Among Adults in East Africa in the "Treat-All" Era.

Despite widespread access to antiretroviral therapy (ART) in the "Treat All" era, HIV-associated Kaposi sarcoma (KS) remains among the most common malignancies in sub-Saharan Africa. Survival after KS diagnosis has historically been poor in Africa, but knowledge whether survival has changed at the population level in the contemporary era has been limited by lack of community-representative surveillance and monitoring systems. We identified all adult persons living with HIV (PLWH) with a new diagnosis of KS made between 2016 and 2019 during outpatient or inpatient care at prototypical primary care-providing medical facilities in Kenya and Uganda using rapid case ascertainment. Participants were subsequently followed for vital status, including community tracking for those who became lost to follow-up. Among 411 participants with newly diagnosed KS, 71% were men, median age was 34 (IQR: 30 to 41) years, and 91% had ACTG T1 tumor extent. Over a median follow-up of 7.8 (IQR: 2.4 to 17.9) months, cumulative incidence of death (95% CI) at months 6, 12 and 18 were 34% (30% to 39%), 41% (36% to 46%) and 45% (40% to 51%), respectively. Having the highest number of anatomic sites (11 to 16) harboring KS lesions (hazard ratio 2.2 (95% CI: 1.3-3.8) compared to 1 to 3 sites) and presence of oral KS lesions (hazard ratio 2.2 (95% CI: 1.4-3.3)) were independently associated with higher mortality. Lower hemoglobin and CD4 count as well as higher plasma HIV RNA were also associated with higher mortality. Among PLWH with newly diagnosed KS in East Africa in the "Treat All" era, survival was poor and related to mucocutaneous extent of KS. The findings emphasize the need for better control of KS in Africa, including novel approaches for earlier detection, better linkage to oncologic care, and more potent therapy.

BI13 (P99) Skin disease in people living with HIV in the UK: a retrospective analysis

Abstract The spectrum of skin disease associated with advanced HIV infection is well described and can vary between countries, potentially as a result of genetic differences and access to antiretroviral treatment (ART). Effective ART has modified the skin manifestations of HIV in the modern era. The aim of this study was to characterize the profile of skin disease in a UK-based population of people living with HIV (PLHIV). A retrospective review of inpatient admission records was conducted for all patients admitted to a tertiary hospital between June 2020 and October 2022. Data were collected using a standardized data extraction form in Microsoft Excel. Descriptive analysis was undertaken within Excel. Ninety-seven patients were identified (median age 55 years), of whom 82 (85%) were male. Median duration of HIV infection was 15 years [interquartile range (IQR) 8.66–19.58], with a median duration on ART of 9 years (IQR 3–16). Fourteen patients were ART naïve and were diagnosed as being HIV positive on admission. Median CD4 count at presentation was 351 × 106 cells L–1 (IQR 136–579). Fifty-five patients presented with a single dermatological condition, 30 presented with two and 10 presented with three. Of the conditions identified, 48% were skin infections, 18% were skin tumours, 10% were inflammatory dermatoses and 2.8% were drug reactions. In the remaining 21%, the diagnosis was unknown; this included rashes (44%), skin lesions (33%) and ulcers (22%). The most common dermatological condition identified was cellulitis (n = 18; 19%). Of the infections seen, 46% were primary bacterial infections, 27% were primary viral infections, 22% were primary fungal, 3% were primary parasitic and 1% were systemic bacterial infection with skin involvement. Ten per cent of patients presented with Kaposi sarcoma, an AIDS-defining illness. Of the 97 patients, 27% presented with advanced HIV (CD4 < 200 × 106 cells L–1). The most common conditions in this group were oral candidiasis (30%), cellulitis (15%), seborrhoeic dermatitis (15%) and Kaposi sarcoma (15%). Bacterial skin infections were the most common dermatological conditions overall, while oral candidiasis was the most common condition in those with advanced HIV. The causes of almost one-quarter of dermatological presentations were unknown during inpatient admission, highlighting the importance of expert dermatological input. Further work is needed to validate these findings in a larger population of PLHIV, including those managed in an outpatient setting.

P99 Skin disease in people living with HIV in the UK: a retrospective analysis

Abstract The spectrum of skin disease associated with advanced HIV infection is well described and can vary between countries, potentially as a result of genetic differences and access to antiretroviral treatment (ART). Effective ART has modified the skin manifestations of HIV in the modern era. The aim of this study was to characterize the profile of skin disease in a UK-based population of people living with HIV (PLHIV). A retrospective review of inpatient admission records was conducted of all patients admitted to a tertiary hospital between June 2020 and October 2022. Data were collected using a standardized data extraction form in Microsoft Excel. Descriptive analysis was undertaken within Excel. Ninety-seven patients were identified (median age 55 years), of whom 82 (85%) were male. Median duration of HIV infection was 15 years [interquartile range (IQR) 8.66–19.58], with a median duration on ART of 9 years (IQR 3–16). Fourteen patients were ART naïve and were diagnosed as being HIV positive on admission. Median CD4 count at presentation was 351 × 106 cells L−1 (IQR 136–579). Fifty-five patients presented with a single dermatological condition, 30 presented with 2 and 10 presented with 3. Of the conditions identified, 48% were skin infections, 18% were skin tumours, 10% were inflammatory dermatoses and 2.8% were drug reactions. In the remaining 21%, the diagnosis was unknown; this included rashes (44%), skin lesions (33%) and ulcers (22%). The most common dermatological condition identified was cellulitis (n = 18; 19%). Of the infections seen, 46% were primary bacterial infections, 27% were primary viral infections, 22% were primary fungal, 3% were primary parasitic and 1% were systemic bacterial infection with skin involvement. Ten per cent of patients presented with Kaposi sarcoma, an AIDS-defining illness. Of the 97 patients, 27% presented with advanced HIV (CD4 < 200 × 106 cells L−1). The most common conditions in this group were oral candidiasis (30%), cellulitis (15%), seborrhoeic dermatitis (15%) and Kaposi sarcoma (15%). Bacterial skin infections were the most common dermatological conditions overall, while oral candidiasis was the most common condition in those with advanced HIV. The causes of almost one-quarter of dermatological presentations were unknown during inpatient admission, highlighting the importance of expert dermatological input. Further work is needed to validate these findings in a larger population of PLHIV, including those managed in an outpatient setting.

Prevalence of oral lesions in patients with AIDS: a systematic review and meta-analysis.

Background Oral lesions are considered to be early clinical signs which may predict the progression of patients with acquired immune deficiency syndrome (AIDS). Due to the lack of a comprehensive study that includes oral lesions in people with AIDS, the global prevalence of oral lesions in people with AIDS was estimated by combining preliminary studies' results using meta-analysis.Material and methods Databases including PubMed, Science Direct and Scopus were searched using keywords as 'HIV', 'AIDS', 'oral candidiasis', 'Kaposi Sarcoma', 'LinearGingival Erythema' and OR operators, AND and NOT. After the elimination of duplicate documents, articles that met the inclusion criteria were selected. Quality assessment was performed based on the Newcastle-Ottawa Scale. After combining the results of preliminary studies, an overall estimate of each lesion was reported. Ninety-five studies met the criteria for inclusion in this meta-analysis.Results The global prevalence of 21 oral lesions in HIV-infected patients was estimated. The overall prevalence of oral candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, Kaposi sarcoma and erythematous candidiasis was as follows: 35% (95% CI: 28-42), 19% (95% CI: 15-22), 12% (95% CI: 11-14), 5% (95% CI: 4-6) and 18% (95% CI: 14-22).Conclusion The present meta-analysis showed that oral lesions have a high prevalence in patients with AIDS. Dentists should consider that the clinical appearance of the oral cavity reflects the overall systemic health of the patient. As such, oral lesions may be linked to underlying immunosuppression caused by AIDS.

Change in profile of cutaneous manifestations of HIV after the advent of antiretroviral therapy: a retrospective analysis

<p><strong>Background: </strong>To date, there has been no study conducted in Zambia to determine the prevalence of mucocutaneous conditions among HIV positive patients on antiretroviral therapy.<strong></strong></p><p><strong>Methods: </strong>The aim of the study was to determine the differences in cutaneous manifestations of HIV between HIV positive adult patients on antiretroviral therapy and antiretroviral naïve patients.</p><p><strong>Results: </strong>A total of 143 adult HIV/AIDS patients with dermatological manifestations, and fulfilling inclusion criteria, were included. Among the 58 patients on antiretroviral therapy, the most common dermatoses were hyper-pigmentation (18.97%), fungal dermatitis (17.24%) genital herpes (8.62%), papular pruritic eruption (8.62%), oral candidiasis (8.62%) and Kaposi’s sarcoma (6.9%). The most common dermatoses among the 85 antiretroviral naive patients were oral candidiasis (34.12%), herpes Zoster (17.65%), hyper pigmentation (8.24%), eosinophillic folliculitis (7.06%), abscesses (5.88%), herpes labialis (4.71%) and Kaposi's sarcoma (4.71%). Among patients in Stage III of HIV infection, the proportion of patients with infectious dermatoses was significantly greater than the proportion of patients with non-infectious dermatoses (47.5% versus 28.6%; p=0.036).The odds of having an infectious dermatosis were 28% lower for patients on antiretroviral therapy as compared to antiretroviral naive patients (p=0.001).<strong></strong></p><p><strong>Conclusions: </strong>There is a changing profile of muco-cutaneous conditions in HIV infected patients. Infectious dermatoses such as oral candidiasis and Herpes Zoster infections occur more frequently in antiretroviral naïve patients, as compared to patients on ART. Prevention of infectious dermatological conditions occurs with the use of ART.<strong></strong></p>

Kaposi's Sarcoma and Lymphoedema in a HIV Sero-positive Patient: A Case Report and Literature Review

Kaposi sarcoma (KS) is one of the most common neoplasms diagnosed in HIV- seropositive subjects. KS is an angioproliferative disorder of endothelial origin and is a locally aggressive multicentric mucocutaneous malignant neoplasm. Aggressive HIV-KS is associated with increased HHV8 viral load, disseminated lesions, and intraoral exophytic lesions, and may also present with facial lymphoedema which may be life-threatening or mild.
 A 26 -year-old, male, presented with severe oral pain and facial swelling. He had multiple oral lesions and an incisional biopsy confirmed Kaposi sarcoma. A multiple site incisional biopsy and immunohistochemistry for HHV8 was done and based on the clinical, histopathological, and immunohistochemical results a diagnosis of HIV associated oral and cutaneous KS with severe lymphoedema was confirmed.
 This aim of this case presentation is to describe a case of immunodeficiency virus-related lymphadenitis, oral and cutaneous KS associated with the complication severe lymphoedema in a HIV infected patient who was not on HAART therapy for three years after being diagnosed with HIV.

Clinical and Laboratory Profile of People Living with HIV/AIDS with Oral Kaposi Sarcoma.

The aim of this article was to evaluate the clinical and laboratory profile of people with oral Kaposi's sarcoma (KS) associated with AIDS (KS-AIDS), followed-up at a public university hospital in Salvador, Bahia, Brazil, in the past 10 years. We identified patients diagnosed with KS-AIDS, presenting oral manifestation from January 2007 to December 2017. We searched, in the hospital information systems, the patient demographics, diagnostic data, treatment, image studies, and oral photographic records. Of the 39 cases of KS-AIDS identified at the institution, 14 (22.8%) presented oral lesions. There was a predominance of black men, with a mean age of 32.5 years. Most cases (85.1%) manifested signs of KS simultaneously with the diagnosis of HIV infection, with extremely low initial CD4 T cell counts (average of 52.6 cells/mm2) and visceral involvement (64.3%). The palate (32.1%) and gingiva (21.4%) were the most affected oral sites. Histologically, the tumors exhibited proliferation of spindle cells between vascular clefts and extravasated erythrocytes. Oral KS-AIDS was frequent in young black adult men, with severe immunosuppression and high viral load counting, mostly with lesions manifested in the same period of diagnosis of infection by the HIV.

Beyond T Staging in the "Treat-All" Era: Severity and Heterogeneity of Kaposi Sarcoma in East Africa.

Although many patients with Kaposi sarcoma (KS) in sub-Saharan Africa are diagnosed with AIDS Clinical Trials Group (ACTG) T1 disease, T1 staging insufficiently captures clinical heterogeneity of advanced KS. Using a representative community-based sample, we detailed disease severity at diagnosis to inform KS staging and treatment in sub-Saharan Africa. We performed rapid case ascertainment on people living with HIV, aged 18 years or older, newly diagnosed with KS from 2016 to 2019 at 3 clinic sites in Kenya and Uganda to ascertain disease stage as close as possible to diagnosis. We reported KS severity using ACTG and WHO staging criteria and detailed measurements that are not captured in the current staging systems. We performed rapid case ascertainment within 1 month for 241 adults newly diagnosed with KS out of 389 adult patients with suspected KS. The study was 68% men with median age 35 years and median CD4 count 239. Most of the patients had advanced disease, with 82% qualifying as ACTG T1 and 64% as WHO severe/symptomatic KS. The most common ACTG T1 qualifiers were edema (79%), tumor-associated ulceration (24%), extensive oral KS (9%), pulmonary KS (7%), and gastrointestinal KS (4%). There was marked heterogeneity within T1 KS, with 25% of patients having 2 T1 qualifying symptoms and 3% having 3 or more. Most of the patients newly diagnosed with KS had advanced stage disease, even in the current antiretroviral therapy "treat-all" era. We observed great clinical heterogeneity among advanced stage patients, leading to questions about whether all patients with advanced KS require the same treatment strategy.

Diode laser as local treatment for oral Kaposi's sarcoma in HIV young patient: a case report

Introduction: Kaposi's sarcoma (KS) is a malignant mucocutaneous neoplasm caused by human herpesvirus 8 (HHV-8). Four types of KS exist and, in each of them, the patient could develop skin and visceral lesions. Surgical excision, radiotherapy, intralesional chemotherapy and systemic chemotherapy are widely accepted as treatment options. Observation: The aim of this paper is to present diode laser as minimally invasive procedure in management of oral KS. We report here a case of multiple oral lesions of acquired immunodeficiency syndrome (AIDS)-associated KS, which has been solely treated with diode laser. Discussion: There is no bibliography on local treatment of oral KS with diode laser and this clinical case appears to be the first regarding this technique. Conclusion: This conservative approach, in association with highly active antiretroviral therapy (HAART), is safe and effective, shows fewer side effects than chemotherapy, radiotherapy and surgical excision and may be evaluated as potential treatment for oral KS.

Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio.

Background Kaposi’s sarcoma (KS) is an uncommon, multifocal and angioproliferative lesion, which demonstrates a poor prognosis. The aim of the present research was to explore the association of HIV viral load, CD4+ and CD8+ counts and the CD4+/CD8+ ratio on the risk of oral Kaposi’s sarcoma (KS) development.Material and Methods A total of 62 patients were retrieved from March 2008 to October 2020 from the files of two oral pathology centres. Clinical, laboratory and follow-up data were retrieved from their medical files. Poisson regression was used to explore the role of history of immunosuppression and its association with oral KS development. A P-value <0.05 was considered significant.Results Sixty-two patients were included in the present study (32 with oral KS and 30 with no presentation of lesions anywhere on the body). Patients with oral KS presented a mean age of 32.6 years, and male patients were more affected. The hard palate (15 cases; 46.8%) was the main anatomical site affected. The lesions were mostly presented as swellings (13 cases; 40.6%) and nodules (12 cases; 37.5%). Systemic manifestations were also observed, including candidiasis (4 cases; 12.5%), bacterial infection (3 cases; 9.3%), tuberculosis (3 cases; 9.3%), herpes simplex (3 cases; 9.3%) and pneumonia (3 cases; 9.3%). A significant correlation was observed between HIV viral load, CD4+ count and the CD4+/CD8+ ratio with oral KS development.Conclusions HIV viral load, CD4+ count and the CD4+/CD8+ ratio are associated with oral KS development. Key words:Cancer, oral, Kaposi’s sarcoma, diagnostic.

Sarcoma de Kaposi na Odontologia: Um levantamento epidemiológico no Brasil.

HIV-AIDS é um problema de saúde pública no mundo. Em 2014, foram notificados 9.888 novos casos no Brasil e estima-se que metade dos pacientes desconhecem ser portadores da doença. O sarcoma de Kaposi associado à AIDS (KS-AIDS) é um marcador de progressão da doença e imunossupressão. Embora a incidência de SK-AIDS na cavidade oral tenha diminuído notavelmente desde o acesso universal ao tratamento retroviral altamente ativo, há estudos em São paulo que estabelecem uma incidência dessa neoplasia em 5%. A síndrome de reconstituição imunológica associada ao KS-AIDS e ao linfedema facial é uma complicação com risco de vida. A falta de treinamento no diagnóstico oral do SK-AIDS e sua incidência relativamente baixa podem fazer com que essa neoplasia passe despercebida pelo clínico no exame de rotina, sendo este um sinal clínico característico de imunossupressão. Este artigo analisa o SK oral associado à AIDS.

ACQUIRED IMMUNODEFICIENCY SYNDROME ORAL MANIFESTATIONS: A CASE SERIES

Acquired immunodeficiency syndrome (AIDS) is a chronic systemic disease. This condition can be manifested if the patient is infected by the human immunodeficiency virus (HIV). This virus attacks the immune system and interferes in the host resistance. Consequently, infected organisms become immunosuppressed and susceptible to acquiring other opportunistic infections and injuries. The HIV-related diseases most frequent in the oral cavity are candidiasis, gingivitis, oral hairy leukoplakia, herpes simplex, and Kaposi sarcoma. The objective of this study is to report 4 clinical cases of patients with the oral disorders listed above. AIDS oral manifestations may represent the first clinical signs of HIV infection. Therefore, knowledge of oral lesions associated with HIV infection is extremely important for the oral surgeon. Based on this, the health professional can make the HIV diagnosis of this complex systemic disease, in some cases not previously diagnosed.

&lt;p&gt;Assessing the levels of HIV-related knowledge and attitudes toward HIV-infected patients among undergraduate dental students: a cross-sectional study&lt;/p&gt;

PurposeWorldwide, in the last decade, the numbers of new HIV infections and AIDS-related deaths have drastically decreased. Despite that, around 18 million infected individuals receive antiretroviral therapy and thus tend to live longer. This cross-sectional study was conducted to assess the level of HIV-related knowledge among undergraduate dental students at Ain Shams University (ASU) in Cairo, Egypt and to determine their attitudes toward treating HIV-positive patients.MethodsThe study sample included 247 undergraduate dental students of third, fourth, and fifth academic years at the Faculty of Dentistry, ASU who were randomly selected to participate in this survey. Data were collected using a self-administrated anonymous questionnaire. Chi square and ANOVA tests were used to measure differences in the level of knowledge and attitudes among students of the 3 years. Multiple linear regression analysis was performed with 95% confidence interval.ResultsWithin the students’ population, around 94% incorrectly considered dentists to be at high risk of acquiring HIV infection and 47% believed that saliva is a vehicle for its transmission. Moreover, the majority of students were unaware of the association between HIV and common oral manifestations such as oral candida, Kaposi sarcoma, and leukoplakia. Although 69% of the students were willing to deliver oral care to people living with HIV (PLHIV), only 33% perceived themselves knowledgeable enough to do so.ConclusionDental students were not adequately prepared to recognize and manage HIV-positive individuals. Thus, better education and training are required to raise their levels of HIV-related knowledge and enhance their capabilities to treat PLHIV.

Endemic Kaposi sarcoma in HIV-negative children and adolescents: an evaluation of overlapping and distinct clinical features in comparison with HIV-related disease

BackgroundEndemic Kaposi sarcoma (KS) was first described in African children over fifty years ago, but has recently been overshadowed by HIV-related disease. We aimed to evaluate the similarities and differences between endemic HIV-negative and epidemic HIV-positive pediatric KS in a KS-associated herpesvirus-endemic region of Africa.MethodsWe describe clinical characteristics of 20 HIV-negative children with endemic KS over a six-year period and compare findings with a historical control—an HIV-related pediatric KS cohort from Lilongwe, Malawi.ResultsThe HIV-negative endemic KS cohort was 70% male with a median age of 9.3 years. Lymph node involvement was present in 50%, hyperpigmented skin lesions in 45%, and woody edema in 40%. One patient (5%) presented with oral KS involvement and no patients presented initially with visceral KS. Significant anemia (hemoglobin < 8 g/dL) and thrombocytopenia (platelet count < 100 × 109/L) were found at time of original KS diagnosis in 45 and 40% respectively. In both HIV-negative and HIV-positive cohorts, lymphadenopathy was the most common presentation, prototypical skin lesions were often absent, severe cytopenias were a common clinical feature, and treatment outcomes were similar. Patients with endemic KS demonstrated less frequent oral involvement (5% versus 29%, P = 0.03) and a lower proportion of patients with visceral involvement (0% versus 16%, P = 0.06).ConclusionsThese data suggest clinical overlap between epidemiological variants. Treatment protocols for pediatric KS in sub-Saharan Africa should be devised to include both endemic HIV-negative and epidemic HIV-related disease to better define the clinical and biological comparison.

Oral Kaposi's Sarcoma: Multiple Presentation in an HIV Seropositive Patient

Oral Kaposi's Sarcoma: Multiple Presentation in an HIV Seropositive Patient

A case of extensive oral kaposi's sarcoma in a patient with undiagnosed HIV infection

Abstract: Kaposi's sarcoma (KS) is a multifocal soft tissue tumour estimated to affect up to 1 in 20 HIV-infected individuals. Oral involvement is commonly the initial presentation, making it important that oral health providers are able to recognize oral disease in all stages of progression. Its various clinical stages (patch, plaque, nodular) can often mimic other benign lesions, such as pyogenic granuloma, potentially leading to misdiagnosis. This article aims to help improve recognition of KS amongst oral health professionals by raising awareness of its oral features. It is hoped that this will aid in early diagnosis and improved outcomes for patients.CPD/Clinical Relevance: Kaposi's sarcoma is a common tumour amongst HIV-infected individuals often presenting with oral involvement. Recognition of the tumour, especially at the early stages, allows for early diagnosis and treatment, helping to improve patient prognosis.

Pathology of Candida infection in oral HIV-associated Kaposi sarcoma: A descriptive study

Pathology of Candida infection in oral HIV-associated Kaposi sarcoma: A descriptive study

Angiopoietin‐2 is expressed in oral Kaposi's sarcoma

Kaposi's sarcoma (KS) persists today as a highly prevalent vascular cancer, often found in HIV patients. Studies have shown that angiopoietin 2 (Ang2), a pro-angiogenic protein, is involved in the pathogenesis of this tumor. However, expression of this protein has not been investigated in oral KS lesions. Thus, we aimed to investigate the expression of Ang2 in samples of oral KS. Immunohistochemistry was used to evaluate Ang2 expression in 14 oral KS cases, with degrees of expression being analyzed in a semi-quantitative manner. In addition, clinical information such as age, gender, race, tumor location, size, color, and appearance, as well as HIV status, was collected and included in the analysis. All patients were white males, mostly HIV-positive, with a mean age of 40years. Clinically, the lesions were dark red/blue/purple masses, ranging from 1 to 2.5cm in diameter, found in various locations such as the tongue, palate, and gingiva. Expression of Ang2 was noted in 72% (10/14) of the samples. Of these, 10% showed weak expression, 60% moderate, and 30% strong expression. Our results indicate that Ang2 is expressed in oral KS and, consistent with results from previous studies, show that Ang2 may contribute to the pathogenesis of this lesion.

ORAL KAPOSIS SARCOMA RELATED TO AIDS IN LATE STAGE

Kaposi sarcoma (KS) is one of the most common neoplasms diagnosed in HIV positive patients. The mortality rate of patients with oral HIV-KS is greater than patients with only cutaneous HIV-KS. On April, 2011, a male patient, 35 years old, MSM HIV+, was admitted at the Service of Oral Medicine with count of CD4+ of 87 cells/cc3, CD8+ of 602 cell/cc3, and viral load of 355 copies/ml. It was found alopecia, malnutrition, brown maculae on forearm and foot (KS). The intraoral examination showed angular fissure (angular cheilitis), atrophy of dorsal tongue papillae, white plaques on the jugal and soft palate (candidosis). In the hard palate was noted enlargement purple and ulcerated and painless (KS). The KS was treated with radiotherapy. Nowadays, he is controlled, the HIV load is low. This evolution was unexpected for a patient with oral KS in advanced stage of AIDS progression.

Imaging Findings in AIDS-related Oral Kaposi's Sarcoma.

Kaposi's sarcoma (KS) is one of the most common diseases in patients with acquired immunodeficiency syndrome, but is rarely encountered in dental practice in Japan. We encountered a case of oral KS (OKS) presenting in the hard palate, gingiva, and tongue in a 41-year-old man. We report the results of imaging, including computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT in this case. The process leading to an imaging diagnosis of OKS is discussed, emphasizing the importance of collating clinical, laboratory, pathological, and radiological findings. The present results suggest that mapping of accurate tumors is very important in cases of OKS, and that multiple or bilateral manifestations, ill-defined margins, osteolysis, and swollen lymph nodes, in particular, need to be taken into account.