Kaposi's sarcoma of the head and neck in acquired immunodeficiency syndrome

Kaposi's sarcoma has emerged from obscurity to become a common treatment problem. Otolaryngologists can play a key role in diagnosis and treatment of the victims of AIDS given the frequency of involvement of the head and neck. Kaposi's sarcoma involvement of the head and neck is often the presenting symptom of AIDS, making accuracy in diagnosis critical if intervention is to begin early. KS is rarely the cause of death in these patients, although it can cause significant morbidity. Treatment is currently directed toward palliation for pain, bleeding, dysphagia, airway obstruction, severe disfigurement, and prophylaxis for rapidly progressive tumor. The choice of treatment is dependent on the symptoms, location, and extent of the lesion. Radiation, chemotherapy, and alpha interferon form the core of treatment, with the former two more commonly used. The general medical condition of the patient must be considered, particularly when systemic treatment is contemplated. Future directions of therapy may be directed toward optimizing combination therapy and modification of the underlying immunodeficiency to allow the body's own compromised immunity to cause regression of the tumor.