Kaposi’s sarcoma

Definition
Kaposi’s sarcoma is a malignant tumor of the connective tissue, often associated with AIDS.

Causes, incidence, and risk factors

Before the AIDS epidemic, Kaposi’s sarcoma was seen primarily in elderly Italian and Jewish men, and rarely, in elderly women. Among this population the lesions developed slowly. In AIDS patients, it can develop aggressively and involve the skin, lungs, gastrointestinal tract, and other organs.

In people with AIDS, Kaposi’s sarcoma is caused by an interaction between HIV, immune system suppression, and human herpesvirus-8 (HHV-8). Occurence of Kaposi’s sarcoma and has been linked to sexual transmission of HIV and HHV-8.

The tumors consist of bluish-red or purple lesions on the skin. They may first appear on the feet or ankles, thighs, arms, hands, face, or any other part of the body.

Symptoms

     
  • Bluish-red, flat or raised lesions with an irregular shape  
  • Bleeding from gastrointestinal lesions  
  • Shortness of breath from lesions in the lung  
  • Bloody sputum from lesions in the lung

Signs and tests
The following tests may be performed to diagnose Kaposi’s sarcoma:

     
  • Skin lesion biopsy  
  • Endoscopy

Treatment

Treatment decisions depend on the extent and location of the lesions, as well as the person’s symptoms and degree of immunosuppression. Antiviral therapy against the AIDS virus can shrink the lesions.

Radiation therapy or cryotherapy can be used for lesions in certain areas. Combination chemotherapy may also be used. However, lesions may return after treatment.

Expectations (prognosis)

Treatment and remission of Kaposi’s sarcoma does not improve the chances of survival from AIDS itself. The outlook depends on the immune status and HIV viral load of the patient.

Complications

Kaposi’s sarcoma can involve the lungs and cause significant symptoms, including cough and shortness of breath. This diagnosis is made by a CT scan of the chest and a bronchoscopy. The tumors can return even after apparently successful treatment. Kaposi’s sarcoma can be fatal for a person with AIDS.

Prevention
Safe sexual practices can prevent infection with HIV, which in turn prevents the development of AIDS and its complications, including Kaposi’s sarcoma.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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