Chylothorax and Chylous Ascites in AIDS-Associated Kaposi's Sarcoma： A Case Report and Literature Review

Abstract

Background: Kaposi's sarcoma (KS) is one of the most common tumors in patients with AIDS, while the occurrence of chylous effusions in Kaposi's sarcoma patients is rare and often indicates a poor prognosis. This report presents a case of successful management of an AIDS patient with Kaposi's sarcoma who developed both chylothorax and chylous ascites, along with a review of the relevant literature. Case presentation: A 31-year-old male patient, who was recently diagnosed with HIV infection and oral Kaposi's sarcoma at our clinic center, returned two weeks post-discharge. He reported significant enlargement of the oral tumor, increased abdominal girth with accompanying abdominal distension and pain, and a dry cough over the past week. Upon readmission, CT scans indicated the presence of extensive pleural and abdominal effusions. Aspirates from both the pleural and abdominal effusions exhibited a milky chylous appearance. After eliminating other potential etiologies for the chylous effusion, we associated it with the progression of Kaposi's sarcoma. The patient's condition was ultimately successfully managed through a combination of antiretroviral therapy, systemic chemotherapy, and intermittent thoracoabdominal paracentesis for drainage. Conclusion: The emergence of chylothorax and chylous ascites should arouse suspicion of Kaposi's sarcoma, and the presence of chylous effusions in Kaposi's sarcoma patients is an indication of disease progression. Prompt diagnosis and systemic treatment are crucial for the prognosis.