Home / Treatment / Kaposi's Sarcoma

Kaposi's Sarcoma

What is Kaposi's sarcoma?

Kaposi's sarcoma – a form of multiple malignancies on the skin. Disease was first described in the writings of the Hungarian dermatologist Moritz Kaposi, from which it received its name.

Due to the appearance of tumors, the disease is sometimes called hemorrhagic Kaposi's sarcoma. Localization of the tumors is not restricted to the skin, often affecting the internal organs, mucous membranes and lymph nodes.

The content of the article:


The reasons for the development of Kaposi's sarcoma

The disease is not very common among the population, but in HIV-infected men, particularly, is manifested in almost half the cases.

It is for certain the causes of the appearance of these tumors is not known. But scientists with high probability assume that the disease can develop in the setting of human herpes virus 8th type, which in itself is still not well understood.

Also often accompanied by Kaposi's sarcoma other malignancies, including:

For pathology requires a significant lowering of the immunity of the person due to various reasons. In addition, some groups of people the risk of Kaposi's sarcoma is much higher than the rest. For example, most often the disease occurs in men than in women.

In the group of risk are:

  • HIV-infected persons

  • older men belonging to the Mediterranean race
  • persons native to Equatorial Africa
  • face transplant recipients from donor organs (especially the kidney)

Medical scientists are unanimous in one: often, especially in the initial stages, this disease is more reactiveprocess (that is, arising in response to infection), than a true sarcoma.


Possible complications of the disease

Complications of Kaposi's sarcoma depends on the stage of disease and localization of tumors. You may receive the following complications:

  • restriction of motor activity of the limbs and their deformation
  • bleeding from the disintegrating tumors
  • intoxication caused by the breakdown of tumors
  • lymphatic edema, elephantiasis as a result of the displacement of the lymph nodes
  • a bacterial infection of a damaged tumors
  • disruption of the internal organs with the localization of their tumors

Some complications lead to life-threatening human conditions.


Common symptoms of Kaposi's sarcoma

To suspect the development of Kaposi's sarcoma is possible with the appearance of the first lesions on the skin. Usually they are characterized by:

  • Color is often bright Burgundy, but it is possible from red to blue-violet (by this sign is similar to bruising), when pressing the color does not change. Stain have a glossy surface, sometimes slightly peel.
  • Form – in the form of spots, flat or raised slightly above the surface of the skin. Characterized by a multiplicity of lesions. At the confluence of the spots in the center of tumors may sink down and turn into ulcers.

  • Sensation – tumors almost do not manifest themselves with this symptom. Only when you merge into larger lesions may appear itching, tingling, swelling of the surrounding tissues.

  • In the localization of malignant tumors in the mucous membranes possible signs of depending on the specific location of the lesion (diarrhea, vomiting with blood, cough with bloody sputum, pain when chewing and swallowing food). A great danger to life is the development of tumors in the gastrointestinal tract and the respiratory system.

The disease is slow but steadily progressive. If damaged spots and bleeding, as they are basically a network of blood vessels. Symptoms of the disease depends on the subtype.


Typical varieties of Kaposi's sarcoma

Kaposi's sarcoma can occur in any type of classifieddoctors depending on the symptoms, site distribution and forecast.

There are 4 typical varieties of this disease:

Classic type

Characteristic of European countries. Stains of the tumor with clear boundaries are localized on the feet, legs and hands. Rarely accompanied by itching or burning.

Disease, current on this type goes through several stages:

  • spotted (characterized by the appearance of smooth patches with uneven edges with a diameter of 5 mm)
  • papular (spots take the form of spheres, become dense, increase in size to 1 cmmay merge , forming a pocket in a flattened shape with a rough surface)
  • tumor (characterized by the formation of nodes of a violet hue, which may be more or less dense, ulcerate)

Endemic type

Circulated among the inhabitants of Central Africa. Different appearance in infancy (in children up to 1 year), localization in the tissues of internal organs and lymph nodes, absence of skin lesions.

Epidemic type

Associated with HIV infection. Is sufficient for AIDS diagnosis. Affects individuals quite young age (40 years). Spots of bright red color, the localization of the bow, upper limb, upper palate in the mouth cavity, be sure there are lesions of the mucous membranes, lymph nodes and internal organs. It is the most fleeting and ginepraia form of Kaposi's sarcoma.

Immunosupressivny type

Has a positive Outlook. Most often occurs after transplantation of donor kidneys as a result of taking specific medicines – immunosuppressants. If you cancel drugs, the disease regresses.

In addition, the disease can occur in acute, subacute and chronic forms. In acute period has seen rapid progress and frequent adverse outcome. For the subacute form is dependent on the efficiency of therapeutic effects. The most favorable prognosis is observed in chronic forms of the disease, when the patient can do without the treatment measures for more than 10 years.

The type of Kaposi's sarcoma is determined by the result of diagnostic procedures.


Diagnosis of the disease

Often the exact diagnosis of Kaposi's sarcoma can be installed without various studies, the so bright clinical manifestations has this disease. Enougha careful examination by a specialist of the skin, the mucous membranes of the mouth and genitals. Besides, the biopsy may reveal a bleeding because the tumor consists of proliferating vessels.

But in the event that a specialist of doubt and to differentiate this disease are assigned to diagnostic measures:

  • Method of laboratory tests (PCR) can detect the presence in the body of the herpes virus of the 8th type, and antibodies thereto. This method will not reliably indicate the presence of Kaposi's sarcoma or the possibility of its development, but confirmation of the diagnosis will help to better assign measures of drug exposure.
  • Mandatory the patient is analyzed for the presence of HIV infection.
  • Histological study will help to differentiate this disease from cm, showing among other things the presence of hemorrhagic component.
  • If you suspect a tumor localization in the respiratory tract, the gastrointestinal tract (what can be said of the complaints of the patient) is assigned the investigation of these systems by suitable methods (bronchoscopy or chest x-ray, gastroscopy and colonoscopy for examination of the digestive system).
  • Perhaps the appointment of immunogram status of cellular immunity, since the disease occurs on the background of his significant decline.
  • May require additional activities in the form of ultrasound examination of the abdominal cavity, CT of kidneys, MRI of the adrenal glands, bone scintigraphy. Thus, the physician can obtain the most complete picture of lesions of the internal organs.

Sometimes the doctor may need differentiation of Kaposi sarcoma from similar manifestations of the disease: lichen planus, of mycosis fungoides, sarcoidosis, hemosiderosis, microvasular hemangioma, melanoma, etc.

The diagnostic results are used when selecting therapeutic measures.

Treatment of Kaposi's sarcoma

Specific treatment of Kaposi's sarcoma often are not. The effect directly on the tumor rarely gives positive results. In General, therapeutic measures aimed at disease, which is accompanied by sarcoma, and on alleviating symptoms and facilitating the General condition of the patient.

Directly on the swelling effect in the following cases:

  • very large size of the tumor
  • if the patient experiences pain, severe burning
  • if the tumor threatens the life of the patient, settling on the mucous membranes of the respiratory tract or the gastrointestinal tract
  • a tumor is a serious cosmetic defect

In these cases, the effect on the tumor can be of two types:

  1. Local impact – the use of radiation therapy, cryotherapy, local application of drugs (Panretin, Prospidin, Dinitrochlorobenzene), the introduction of drugs directly into the tumor. If the tumor is isolated, then carried out a surgical operation – excision of her. About 40% of these operations have consequences as long-term remission, so the method can be called quite successful.

  2. Systemic effects, which, in turn, is conducted in several directions:

    • chemotherapy has side effects, sometimes requires a combination with hormonal therapy, it is necessary to spend up to 4 courses per year
    • antiretroviral therapy contributes to the improvement of the immune status and simultaneous suppression of viral activity, quite a long exposure (at least a year), but sometimes gives good results
    • therapy with interferon is also conducted long courses, has immunomodulatory effects

Local therapy is performed on an outpatient basis, mostly without causing side effects. It is shown at not very large and solitary tumors. The main risk of treatment is the opening of the bleeding from the tumor or the formation of the ulcers, which can lead to infection, because immune status is very low. In addition, the damaged tumor provokes the appearance of new lesions.

Systemic effects often used if the patient is not experiencing symptoms and has no significant immunodeficiency. But in cases when the tumor is life-threatening in nature or causes physical pain, this treatment option is also used.

All methods of treatment used regarding Kaposi's sarcoma, only give them a hope for recovery, but not a guarantee. As a positive result of treatment is considered even reducing the tumor in size, its blanching or absence of new lesions.


The prognosis of Kaposi's sarcoma

The prognosis for this disease depends on its shape, the characteristics of the course and immune status of the patient. At a sufficiently high immune status of tumoreducation can be vulnerable, curative measures yield positive results, allowing them to achieve long-term remission.

In other cases, the prognosis is extremely unfavorable. More than 50% of patients die in a short time (from 2-3 months to 2 years). The sooner sarcoma is progressing, the less chance of a successful combating. Conversely, slow flow gives more opportunities to choose an effective method of influence.

A positive result of treatment of Kaposi's sarcoma does not increase the chances of recovery from AIDS. But for the patient with AIDS , a complication of Kaposi's sarcoma can be fatal.

This does not apply to facts immunosupressivei sarcomas that have benign course and in most cases a favorable outcome.


Prevention of Kaposi's sarcoma

Preventive measures principally to prevent diseases herpes 8 type, immunodeficiency conditions and diseases that may be accompanied by Kaposi's sarcoma.

Essential in the prevention of this disease – a strong immune status. This also applies to cases when there is the disease that can be accompanied by the appearance of Kaposi's sarcoma. Thus, in HIV-infected patients therapy with antiretroviral drugs give good results by allowing you to support the immune system in an active form and to prevent the manifestations of Kaposi's sarcoma.

For patients whose disease is in remission, requires regular monitoring in the form of inspection of the mucous membranes and skin (1 every 3 months), studies of the respiratory tract and the gastrointestinal tract (at least 1 time in half). This will allow time to notice the recurrence of the disease.

Kaposi's sarcoma in many cases life threatening disease. Strong immunity – natural and reliable defender of the body from many diseases. Therefore, it is necessary to take care of the maintenance of protective forces of an organism, and they, in turn, can save you from many problems.