Kaposi's sarcoma with atypical gastrointestinal involvement

Area of Science:

• Oncology
• Infectious Diseases
• Gastroenterology

Background:

• Kaposi sarcoma (KS) is an AIDS-defining malignancy often presenting with skin lesions.
• Gastrointestinal involvement in KS can be asymptomatic or present with vague symptoms, leading to delayed diagnosis.

Purpose of the Study:

• To report a rare case of disseminated Kaposi sarcoma in an HIV-positive individual with extensive gastrointestinal and skin involvement.
• To emphasize the diagnostic challenges and clinical presentation of KS in the context of severe immunosuppression.

Main Methods:

• A case study of a 31-year-old HIV-positive male with symptoms of weight loss, asthenia, and anorexia.
• Physical examination revealed purple papules; laboratory tests showed severe immunosuppression (CD4 count 114 cells/µL).
• Endoscopic procedures (esophagogastroduodenoscopy and colonoscopy) and biopsies were performed to evaluate gastrointestinal lesions and skin papules.

Main Results:

• Biopsies confirmed Kaposi sarcoma, characterized by vascular channel proliferation and atypical endothelial cells, in the esophagus, stomach, duodenum, colon, and skin.
• Endoscopy revealed exophytic esophageal lesions and multiple maculopapular erythematous lesions throughout the gastrointestinal tract.
• Severe immunosuppression was noted, indicated by a low CD4 cell count and high HIV viral load.

Conclusions:

• Disseminated Kaposi sarcoma can present with diverse gastrointestinal manifestations in HIV-positive individuals.
• Early recognition of KS symptoms and prompt endoscopic evaluation are crucial for diagnosis and management in immunocompromised patients.
• This case underscores the importance of considering KS in the differential diagnosis of unexplained gastrointestinal lesions in HIV-infected individuals.