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

Document Type : Case Report


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



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.
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.


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.