Kaposi Sarcom

Kaposi sarcoma (KS) is a type of cancer that starts in the cells that line the lymph or blood vessels. It usually shows up as tumors on the skin or mucosal surfaces, like the inside of the mouth. However, these tumors can also develop in other organs, such as the digestive system, lungs, or lymph nodes, which are bean-shaped collections of immune cells distributed throughout the body.

Last Updated: February 23, 2024

Classic Kaposi sarcoma affects 17 times more men than women. It mainly affects people over 50 from Eastern Europe or the Mediterranean. 

The only known virus that can cause Kaposi sarcoma is human herpesvirus 8, also known as Kaposi sarcoma-associated herpesvirus (KSHV).

Cancerous spots on the skin that are purple, red, or brown and can be flat or raised are often the first sign of Kaposi. These may only show up in one place, or they may be everywhere. Lesions are often found on the feet, legs, and face. Lesions can also happen in the mouth, in the anus, or anywhere else in the GI tract.

When lesions form in the lungs, they can make it hard to breathe or make the person cough up blood. Lesions in the GI tract can cause pain and bleeding, which can lead to anemia in the long run.

When lymph nodes, especially those in the groin, are involved, painful leg swelling can be a sign.

With the presence of signs and symptoms, doctors will perform a physical examination to investigate further the symptoms and to confirm or reject potential diagnoses; they will perform the following:

  • Skin biopsy to  check for signs of cancer in the tissue;
  • Chest Xray to check if cancer has spread to the lungs;
  • Bronchoscopy to take a closer look at the trachea and airways, especially when coughing out blood;
  • Endoscopy to check the source of bleeding in the GI tract. 

Treatment

Kaposi sarcoma that has spread to the skin is treated with a combination of liquid nitrogen and vincristine injected at the tumor site. Treatment for both the endemic and systemic types, especially in adolescents, relies heavily on chemotherapy.

Patients with Kaposi sarcoma-associated with HIV respond favorably to HAART (highly active antiretroviral therapy), which can lead to tumor shrinkage or even cure. It is recommended to use a combination of HAART and chemotherapy for patients with advanced Kaposi sarcoma. Reducing immune suppression or stopping steroid treatment is one option for treating iatrogenic Kaposi sarcoma. However, this must be weighed against the risks of transplant rejection and the necessity of treating the tumor. 

Currently, there are no KSHV vaccinations available to the general public. The best way to prevent KS is to prevent people from getting infected with KSHV.

Avoiding unprotected sex with HIV-positive people can also prevent infection. Many HIV-positive persons do not know they are infected, so using a condom during sex is one of the best protections.

Taking a daily ant-viral medication can also reduce HIV risk. 

The CDC recommends Pre-exposure prophylaxis (PrEP) for HIV-negative, high-risk individuals.

 

References

Bishop BN, Lynch DT. Kaposi Sarcoma. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534839/

Johns Hopkins Medicine (2022). Kaposi Sarcoma. Retrieved December 13, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/sarcoma/kaposi-sarcoma

American Cancer Society (2022). Kaposi Sarcoma. Retrieved December 13, 2022, from https://www.cancer.org/cancer/kaposi-sarcoma/causes-risks-prevention/prevention.html

Last Updated: February 23, 2024