Tonsillar Kaposi Sarcoma in a Patient with Membranous Glomerulonephritis on Immunosuppressive Therapy

Abstract

Kaposi sarcoma is a malignant vascular neoplasm uncommonly seen in immunosuppressed patients. Herein we report an unusual case of tonsillar Kaposi sarcoma in a patient with membranous glomerulonephritis treated with prednisolone and cyclosporine. The patient presented after 10 months of starting the treatment with a tonsillar mass. Histological examination was typical of monomorphic spindle cell proliferation with slit-like vascular channels. The tumor cells expressed CD34, D2-40 and positive nuclear stain for HHV-8. Kaposi sarcoma is associated with immunosuppression and rarely occurs in the tonsil. Clinicians should be aware of this rare presentation of Kaposi sarcoma.

Isolated Kaposi Sarcoma of the Tonsil: A Case Report and Review of the Scientific Literature

“…The AIDS-related KS lesions, affecting the skin of the upper trunk and face [ 2 , 3 ], and the mucosa of the oral cavity [ 19 ], often progress rapidly to plaques and nodules. The oropharyngeal KS and, in particular, isolated KS of the tonsil are extremely rare and only a few cases were described in literature [ 13 , 15 , 16 ]. Raikundalia described the first case of KS located in the upper pole of the left tonsil in a female aged 38.…”

“…No recurrence after 3 years from the tonsillectomy was recorded. Al-Brahim et al [ 15 ] referred to a patient with membranous glomerulonephritis exposed to immunosuppressive therapy. After 10 months of exposure to the therapy the patient developed a tonsil KS.…”

Effective treatment of Kaposi sarcoma with everolimus in a patient with membranous glomerulonephritis

“…African Americans have a fivefold higher risk than the general population. 3 The relative risk in indigenous Australians is unknown.…”

“…Only a few of them describe KS in the course of membranous nephropathy. 3,4 There was only one reported case of mTor inhibitor application as an antineoplastic treatment of KS accompanying membranous nephropathy. 5 The described severe nephrotic syndrome in negative anti-PLA2R membranous nephropathy poorly responding to immunosuppression may accompany or precede the occurrence of KS.…”

Coexistence of Membranous Glomerulonephritis and Kaposi’s Sarcoma: Case Report and Literature Review

“…Kaposi's sarcoma is well known in patients with acquired immunodeficiency syndrome (AIDS), iatrogenic KS mainly affecting recipients of solid organs (especially the kidneys), but rarely plaguing patients with glomerulonephritis under immunosuppressive therapy. To the best of our knowledge, the report of KS in patients with glomerulonephritis is only eight cases described in the literature (2)(3)(4)(5)(6)(7)(8)(9). In this article, we are presenting another rare case of Kaposi sarcoma in a patient with membranous glomerulonephritis on immunosuppressive therapy.…”