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Primary Kaposi sarcoma of the subcutaneous tissue.

Pantanowitz L, Mullen J, Dezube BJ - World J Surg Oncol (2008)

Bottom Line: We present a unique case of acquired immune deficiency syndrome (AIDS)-associated KS manifesting primarily in the subcutaneous tissue of the anterior thigh in a 43-year-old male, which occurred without overlying visible skin changes or concomitant KS disease elsewhere.This is the first documented case of primary subcutaneous KS occurring in the setting of AIDS.The differential diagnosis of an isolated subcutaneous lesion in an human immunodeficiency virus (HIV)-infected individual is broad, and requires both imaging and a histopathological diagnosis to guide appropriate therapy.

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Affiliation: Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA. liron.pantanowitz@bhs.org

ABSTRACT

Background: Involvement of the subcutis by Kaposi sarcoma (KS) occurs primarily when cutaneous KS lesions evolve into deep penetrating nodular tumors. Primary KS of the subcutaneous tissue is an exceptional manifestation of this low-grade vascular neoplasm.

Case presentation: We present a unique case of acquired immune deficiency syndrome (AIDS)-associated KS manifesting primarily in the subcutaneous tissue of the anterior thigh in a 43-year-old male, which occurred without overlying visible skin changes or concomitant KS disease elsewhere. Radiological imaging and tissue biopsy confirmed the diagnosis of KS.

Conclusion: This is the first documented case of primary subcutaneous KS occurring in the setting of AIDS. The differential diagnosis of an isolated subcutaneous lesion in an human immunodeficiency virus (HIV)-infected individual is broad, and requires both imaging and a histopathological diagnosis to guide appropriate therapy.

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Core needle biopsy of Kaposi sarcoma. Fascicles comprised of spindled tumor cells are shown (H&E stain).
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Figure 2: Core needle biopsy of Kaposi sarcoma. Fascicles comprised of spindled tumor cells are shown (H&E stain).

Mentions: An ultrasound test showed a 2.6 × 1.8 × 1.2 cm solid, vascular, heterogeneous lesion within the deep thigh soft tissue. A magnetic resonance image (MRI) showed a solid, vascular enhancing mass with spiculated margins (Figure 1) located within the subcutaneous fat, superficial to muscle, in the left anterior thigh. The mass measured 2.2 cm in greatest diameter, and was associated with a second inferior satellite 1.4 cm subcutaneous tumor. Tumor was isointense to muscle on T1W1 and heterogeneous, but mostly hyperintense on T2WI. After gadolinium administration, both lesions enhanced. The larger index lesion enhanced heterogeneously and vessels were identified entering the proximal and distal aspects (Figure 2). No nodal disease was reported. Fecal occult blood test performed for evidence of gastrointestinal KS was negative and a chest x-ray showed no evidence of pulmonary KS.


Primary Kaposi sarcoma of the subcutaneous tissue.

Pantanowitz L, Mullen J, Dezube BJ - World J Surg Oncol (2008)

Core needle biopsy of Kaposi sarcoma. Fascicles comprised of spindled tumor cells are shown (H&E stain).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2538530&req=5

Figure 2: Core needle biopsy of Kaposi sarcoma. Fascicles comprised of spindled tumor cells are shown (H&E stain).
Mentions: An ultrasound test showed a 2.6 × 1.8 × 1.2 cm solid, vascular, heterogeneous lesion within the deep thigh soft tissue. A magnetic resonance image (MRI) showed a solid, vascular enhancing mass with spiculated margins (Figure 1) located within the subcutaneous fat, superficial to muscle, in the left anterior thigh. The mass measured 2.2 cm in greatest diameter, and was associated with a second inferior satellite 1.4 cm subcutaneous tumor. Tumor was isointense to muscle on T1W1 and heterogeneous, but mostly hyperintense on T2WI. After gadolinium administration, both lesions enhanced. The larger index lesion enhanced heterogeneously and vessels were identified entering the proximal and distal aspects (Figure 2). No nodal disease was reported. Fecal occult blood test performed for evidence of gastrointestinal KS was negative and a chest x-ray showed no evidence of pulmonary KS.

Bottom Line: We present a unique case of acquired immune deficiency syndrome (AIDS)-associated KS manifesting primarily in the subcutaneous tissue of the anterior thigh in a 43-year-old male, which occurred without overlying visible skin changes or concomitant KS disease elsewhere.This is the first documented case of primary subcutaneous KS occurring in the setting of AIDS.The differential diagnosis of an isolated subcutaneous lesion in an human immunodeficiency virus (HIV)-infected individual is broad, and requires both imaging and a histopathological diagnosis to guide appropriate therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA. liron.pantanowitz@bhs.org

ABSTRACT

Background: Involvement of the subcutis by Kaposi sarcoma (KS) occurs primarily when cutaneous KS lesions evolve into deep penetrating nodular tumors. Primary KS of the subcutaneous tissue is an exceptional manifestation of this low-grade vascular neoplasm.

Case presentation: We present a unique case of acquired immune deficiency syndrome (AIDS)-associated KS manifesting primarily in the subcutaneous tissue of the anterior thigh in a 43-year-old male, which occurred without overlying visible skin changes or concomitant KS disease elsewhere. Radiological imaging and tissue biopsy confirmed the diagnosis of KS.

Conclusion: This is the first documented case of primary subcutaneous KS occurring in the setting of AIDS. The differential diagnosis of an isolated subcutaneous lesion in an human immunodeficiency virus (HIV)-infected individual is broad, and requires both imaging and a histopathological diagnosis to guide appropriate therapy.

Show MeSH
Related in: MedlinePlus