Vertebral Lesions from AIDS-Related Kaposi's Sarcoma.

Area of Science:

• Oncology
• Infectious Diseases
• Radiology

Background:

• Kaposi's sarcoma (KS) typically presents with skin or visceral lesions in HIV/AIDS patients.
• Vertebral involvement in KS is rare, especially without concurrent skin lesions.
• KS can occur in HIV-positive individuals even with preserved CD4+ T-cell counts.

Observation:

• A 44-year-old HIV-positive man with a history of KS presented with severe lumbar back pain.
• Imaging revealed a pathological fracture of the L1 vertebra.
• Biopsy confirmed Kaposi's sarcoma as the cause of vertebral involvement.

Findings:

• Despite radiotherapy, the patient experienced limited improvement, with new vertebral lesions appearing on follow-up MRI.
• The case highlights KS occurring in the spine without apparent cutaneous lesions in an HIV-positive individual with a CD4 count of 408 cells/mm³.
• Diagnosis was confirmed through CT/MRI and histological analysis.

Implications:

• Prompt investigation of bone pain in immunosuppressed patients for vertebral Kaposi's sarcoma is essential.
• Accurate diagnosis using advanced imaging and biopsy is critical.
• Integrated treatment with chemotherapy and antiretroviral therapy may prevent severe complications such as spinal cord compression.