Mucosal Kaposi's sarcoma in HIV‐negative patients: a large case series from a single, tertiary referral center in Italy

Abstract

Background Mucosal involvement in HIV‐negative Kaposi's sarcoma (KS) is uncommon but has potentially serious repercussions on patient care. Evidence regarding its epidemiology and optimal management is limited. Invasive endoscopic staging at diagnosis and periodically during follow‐up is currently recommended by major guidelines. Materials and methods We reviewed the clinical records of 1,308 HIV‐negative KS patients followed at our dedicated KS outpatient service. Demographics, clinical characteristics, and treatment outcomes for cases with biopsy proven mucosal lesions were collected. Results Mucosal involvement was documented in 53 patients (4.1% of our cohort), being present at diagnosis in 28 (52.8%) and occurring at a later time in the remaining 25 (47.2%) patients, with a mean latency of 8 years (±7.7). Oral cavity (43.4%) and glans penis (39.6%) were the most frequently involved anatomical sites. Of those with available treatment response data, complete response (CR) of mucosal KS was appreciated in 41 cases (93.2%), while partial response (PR) and stable disease (SD) were documented in one (2.3%) and two cases (4.5%), respectively. Same‐site recurrences were noticed in seven patients (17.1%). Conclusion Mucosal involvement in HIV‐negative KS is rare, and its recurrence, if properly treated, appears to be infrequent. Thus, routine invasive monitoring in this setting may be unnecessary. We propose a tailored approach based on the clinical manifestations of each patient, limiting the indication of invasive procedures to the first evaluation and in case of significant clinical worsening or to monitor known mucosal localizations.

Gastrointestinal Kaposi Sarcoma: A Rare Case of an Isolated Rectal Lesion in an Immunocompetent HIV-Negative Patient

“…Compared with prior reports, our case describes mucosal KS in the rectum which differs from most cases of HIV-negative patients in which oral cavity and glans of the penis were the most frequently involved anatomical sites. 17 KS tends not to present as an isolated GI disease in which asymptomatic lesions are usually left untreated. For symptomatic patients, treatment involves local therapy (excision, radiation, cryotherapy) and systemic chemotherapy for systemic advanced disease.…”

Caracterización clínica y endoscópica del sarcoma de Kaposi gastrointestinal en una institución del suroccidente colombiano entre 2011 y 2020

“…En la literatura se encuentran estudios que describen compromiso en mucosas por SK iatrogénico y clásico con tasas de 73,6% y 26,4%, respectivamente. Las localizaciones más comunes son cavidad oral, estómago, recto, intestino delgado y colon (23) . En la presente cohorte no se contó con detalles sobre las características topográficas de este grupo de pacientes.…”

Kaposi's sarcoma on oral and genital mucosa: In vivo reflectance confocal microscopy features

“…5,6 However, the use of RCM for the diagnosis of KS on mucosa is still poorly documented. [7][8][9] The mucosa is particularly suitable for RCM examination because of the lack of stratum corneum. Its thin epithelium allows to explore deeper tissue levels and to identify with high sensitivity the specific features of KS lesions.…”