Tonsillar Kaposi’s Sarcoma in HIV Positive Patient with Syphilis Infection

Document Type : Case Report

Authors

Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, AOUP “Paolo Giaccone”, Via del Vespro, 133, 90127 Palermo, Italy.

10.22038/ijorl.2024.72743.3463

Abstract

Introduction:
Since the introduction of Highly Active Anti-Retroviral Therapy (HAART), there has been a significant increase in the survival of HIV-infected patients. Consequently, there has been increased attention on the potential neoplastic pathologies, such as Kaposi’s sarcoma, associated with AIDS in these individuals.
 Case Report:
In this case report we present, for the first time, a patient affected by Kaposi's sarcoma of the palatine tonsil with a concomitant syphilis infection. The patient underwent enlarged tonsillectomy and continued antiretroviral therapy. There were no signs of disease recurrence at a 12-month follow-up.
 Conclusions:
Despite the rarity of tonsillar localization of Kaposi's sarcoma, it should be suspected in the presence of an HIV-infected patient. Tonsillectomy effectively controls local disease, but comprehensive patient management requires a multidisciplinary team of healthcare professionals, including infectious disease specialists, pathologists, and oncologists who work together to provide high-quality and coordinated care.

Keywords

Main Subjects


  1. Hengge UR, Ruzicka T, Tyring SK, Stuschke M, Roggendorf M, Schwartz RA et al: Update on Kaposi’s sarcoma and other HHV8 associated diseases. Part 1: epidemiology, environmental predispositions, clinical manifestation, and therapy, Lancet Infect Dis 2002; 2(5):281-292.
  2. Lager I, Altini M, Coleman H, Ali H: Oral Kaposi’s sarcoma: a clinicopathologic study from South Africa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96(6):701–710.
  3. Singh B, Har-el G, Lucente FE: Kaposi’s sarcoma of the head and neck in patients with acquired immunodeficiency syndrome. Otolaryngology Head Neck Surg 1994; 111(5):618–624.
  4. Darling M, Thompson I, Meer M: Oral Kaposi’s sarcoma in a renal transplant patient: case report and literature review. J Can Dent Assoc 2004; 70(9):617–620.
  5. Ficarra G, Berson AM, Silverman S Jr, Quivey JM, Lozada-Nur F, Sooy DD et al: Kaposi’s sarcoma of the oral cavity: a study of 134 patients with a review of the pathogenesis, epidemiology, clinical aspects, and treatment. Oral Surg Oral Med Oral Pathol 1988; 66(5):543–550.

6.                   Lorusso F, Gallina S, Modica, DM, Di Salvo N, Riggio F. Bipolar quantum molecular resonance versus blunt dissection tonsillectomy. B-ENT, 2015;11 (2): 101-108.

  1. Lorusso F, Dispenza F, Modica DM, Gallina S. The role of modified expansion sphincter pharyngoplasty in multilevel obstructive sleep apnea syndrome surgery. Int Arch Otorhinolaryngol 2018;22 (4): 432 – 436.
  2. Sireci F, Dispenza F, Lorusso F, Immordino A, Immordino P, Gallina S et al. Tumours of Nasal Septum: A Retrospective Study of 32 Patients. Int J of Environ Res Public Health 2022;19 (3): 1713.
  3. Delabesse E, Oksenhendler E, Lebbe C, Verola O, Varet B, Turhan AG. Molecular analysis of clonality in Kaposi’s sarcoma. J Clin Pathol 1997; 50(8):664–668.
  4. Tappero JW, Conant MA, Wolfe SF, et al: Kaposi’s sarcoma. Epidemiology, pathogenesis, histology, clinical spectrum, staging criteria and therapy. J Am Acad Dermatol 1993; 28(3):371–395.
  5. Antman K, Chang Y. Kaposi’s sarcoma, N Engl J Med 2000; 342(14):1027– 1038.
  6. Burrascano D, Dolores S, Immordino A, Lorusso F, Dispenza F, Sireci F. A Rare Case of Solitary Fibrosus Tumor (SFT) of the Nasal Septum. Iran J Otorhinolaryngol 2023; 35(131):329-334.
  7. Sireci F, Lorusso F, Dispenza F, Immordino A, Gallina S, Salvago P et al. A Prospective Observational Study on the Role of Immunohistochemical Expression of Orphanin in Laryngeal Squamous Cell Carcinoma Recurrence. J Pers Med 2023;13(8):1211.
  8. Dukers NH, Rezza G: Human herpesvirus 8 epidemiology: what we do and do not know, AIDS 2003; 17(12):1717–1730.
  9. Hengge UR, Ruzicka T, Tyring SK, Roggendorf M, Schwartz RA et al: Update on Kaposi’s sarcoma and other HHV8 associated diseases. Part 2: pathogenesis, Castleman’s disease, and pleural effusion lymphoma, Lancet Infect Dis 2002; 2(6):344–352.
  10. Pantanowitz L, Dezube BJ: Advances in the pathobiology and treatment of Kaposi sarcoma, Curr Opin Oncol 2004; 16(5):443–449.
  11. Portsmouth S, Stebbing J, Gill J, Mandalia S, Bower M, Nelson M, Bower M et al: A comparison of regimens based on non-nucleoside reverse transcriptase inhibitors or protease inhibitors in preventing Kaposi’s sarcoma, AIDS 2003; 17(11): F17–22.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. International Collaboration on HIV and Cancer: Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults, J Natl Cancer Inst 2000; 92(22):1823–1830.
  2. Feller L, Wood NH, Lemmer J: HIV-associated Kaposi sarcoma: pathogenic mechanisms, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(4):521–529.
  3. Chachoua A, Krigel R, Lafleur F, Ostreicher R, Speer M, Laubenstein L et al: Prognostic factors and staging classification of patients with epidemic Kaposi’s sarcoma, J Clin Oncol 1989; 7(6):774–780.
  4. Radu O, Pantanowitz L. Kaposi sarcoma. Arch Pathol Lab Med 2013; 137(2):289-94.
  5. Jin YT, Tsai ST, Yan JJ, Hsiao JH, Lee YY, Su IJ. Detection of Kaposi’s sarcoma-associated herpesvirus-like DNA sequence in vascular lesions. A reliable diagnostic marker for Kaposi’s sarcoma, Am J Clin Pathol 1996; 105(3):360–363.
  6. Penjor D, Chong AW. A case of Kaposi's sarcoma of tonsil with profuse bleeding in an HIV-positive patient. SAGE Open Med Case Rep 2021; 22;9:2050313X211066411.
  7. Wright B. Kaposi's sarcoma of the tonsils. BMJ Case Rep 2017;2017:bcr2017219714.
  8. Howard JH 3rd, Darrow M, Chen LX, Alnimri M, Jen KY. Tonsillar Kaposi sarcoma in a renal transplant patient. Transpl Infect Dis 2020; 22(5): e13347.
  9. Al-Brahim N, Zaki AH, El-Merhi K, Ahmad MS. Tonsillar Kaposi sarcoma in a patient with membranous glomerulonephritis on immunosuppressive therapy. Ear Nose Throat J 2013; 92(7): E1-4.