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    Kaporsi Sarcoma DR Mark

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    kichutensites

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    Kaporsi Sarcoma DR Mark

    Uploaded by

    kichutensites
    7 views18 pages

    Original Title

    Kaporsi Sarcoma Dr Mark

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    7 views18 pages

    Kaporsi Sarcoma DR Mark

    Uploaded by

    kichutensites

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
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    KAPOSI

    SACOMA
    DR MARK MUTUMA
    DEFINITION
    • KS is a spindle cell tumor of endothelial cell origin

    • Varies from mild mucocutaneous disease to extensive organ


    involvement.

    • Linked with human herpesvirus 8 infection (HHV-8)


    Classification
    1. Classic / sporadic or European Ks

    2. African-Endemic KS

    3. Iatrogenic Immunosuppression-Associated

    4. HIV associated/ epidemic


    1. Classical

    • Elderly males (6th decade) of Eastern Europe

    • Legs – main, lymph nodes & abdomen

    • Slowly progressive

    • 10-15yrs survival

    • 35% risk of secondary malignancy.


    2. African Endemic
    • Mainly in Zaire

    • Young adults (35yrs) &young children (3yrs)

    • Males> females

    • Ass with not wearing shoes

    • 5-8 yrs survival for adults and 2-3 yrs for children.
    3. Immunosuppression-
    Associated

    Rare

    • >Solid organ transplant recipients

    • Chronic Rx with immunosuppressants

    • 16.5 mnths after transplant

    • Resolves with cessation of immunosuppression.


    4. HIV Associated
    K.S
    • >Homosexual

    • Rapid progressive

    • Extensive systemic
    involvement

    • Survival - CD4 count &


    opportunistic dses.
    PATHOGENESIS
    • Excessive proliferation of spindle cells from endothelial origin in
    the background of reticular & collagen fibers and mononuclear
    cells.

    • This may result from stimulation of growth factors by HHV-8


    Transmission
    • Saliva
    • Sexual transmission
    • Blood / transfusion
    • Organ transplant
    Distribution

    Widespread or localized

    • Classic K.S. -on feet, legs & hands (Spread


    centripetally)
    -tip of nose,periobital areas, ear,scalp,penis.
    -Rare on trunk

    HIV related- Early face involvement


    -Trunk invovment.
    CLINICAL
    a) SKIN LESIONS
    Begin as ecchymotic-like macules

    Evolve to patches, papules, plaques,nodules and


    tumors.

    Are red, pink or purple

    Most - palpable (firm to hard)

    Oval initially
    • Secondary changes :
    Erosion
    Ulceration
    Crusting
    Hyperkeratosis

    • Lymphydema –lower extremity(confluent of masses of lesion


    due to deeper lymphatic involvement)
    Mucous membranes

    • Oral lesions- 1st in 22%

    • Hard palate – violaceous stain, evolve to papules and


    nodules with cobble stone appearance

    • On soft palate, uvula, pharynx, gingiva &tongue.


    Lab
    • Skin biopsy-Diagnostic

    • Imaging- Internal organ involvement.


    MANAGMENT

    • Classic KS- Radiotherapy

    • Symptomatic African Endemic- Chemotherapy

    • Immunosuppression ass- Regress or discontinue drug

    • HIV related – Chemotherapy & HAART


    • Local therapy on cometic,bulky,bleeding or functional
    disturbing:
    Cryosurgery

    Laser surgery

    Electrosurgery

    Excisional surgery
    DDX
    • Hemangioma

    • Eccymosis

    • Insect bite rxn

    • Melanocytic nevus

    • Dermatofibroma

    • Pyogenic granuloma

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