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Published on: September 14, 2010
Isolated Gastrointestinal Kaposi's Sarcoma: A Case Report
Sandesh R Parajuli1, Maya Pillai1, Bidisha Baral2
1Department of Internal Medicine, Reading Hospital, Reading, PA, USA.
Introduction:
Kaposi sarcoma (KS) is an AIDS-defining malignancy of the vascular endothelium. Gastric KS without skin lesions is rare. We present a case of a newly diagnosed HIV-positive male with gastric KS in the absence of dermatological involvement.
Case Description:
A 25-year-old male with no prior medical history presented with intermittent headaches, weakness, nausea, and abdominal fullness. Examination revealed temporal wasting, conjunctival pallor, and oral thrush. There were no skin manifestations. He was newly diagnosed with human immunodeficiency virus (HIV) (CD4 <35 cells/μL, viral load 276,000 copies/mL) complicated by cryptococcal meningitis and CMV colitis and had lesions suggestive of KS on esophagogastroduodenoscopy (EGD). Gastric biopsy with staining was positive for HHV-8. He received antifungal and CMV treatment, with HAART initiation delayed due to new-onset fever. Despite treatment, his course was complicated by recurrent infections, requiring ICU care. He ultimately passed away due to cardiac arrest three months post-diagnosis.
Conclusion:
Clinicians should maintain a high index of suspicion for gastric Kaposi sarcoma in newly diagnosed HIV patients with nonspecific gastrointestinal (GI) symptoms, even in the absence of skin lesions.
