Primary Kaposi's sarcoma of the head and neck

Kaposi's sarcoma is a cutaneous neoplasm commonly arising in the extremities, and rarely in the mucosa or skin of the head and neck. We discuss nine cases of Kaposi's sarcoma arising in the head and neck region, retrieved from the files of the Armed Forces Institute of Pathology, together with 74 cases from the literature. The commonest mucosal locations include the conjunctiva, palate, tongue, tonsils, and gums; common cutaneous sites are the eyelids, nose, ears, and face. Prognosis, sex distribution, and susceptible population groups for the head and neck tumor are similar to those for the commoner peripheral cutaneous form. Seventy percent of patients were 50 years or older; 15% of tumors occurred in children under 16 years. Children under 16 years were more likely to have initial head and neck involvement. In our series, 7 of 11 tumors in children initially involved the conjunctiva or skin of the eyelid. Recently the incidence of Kaposi's sarcoma has been increasing in patients with acquired immunodeficiency syndrome. The age of incidence for this group is lower; more tumors occur on the upper body, skin, and mucosal surfaces of the head and neck; and the prognosis is poorer than in traditional cases of Kaposi's sarcoma.