Kosmidis Christophoros, Efthimiadis Christopher, Anthimidis Georgios, Karayannopoulou Georgia, Grigoriou Marios, Vassiliadou Kalliopi, Berovali Eleni, Fachantidis Panagiotis, Fahantidis Epaminondas
Department of Surgery, Interbalkan European Medical Center, Thessaloniki, Greece.
J Med Case Rep. 2008 Jun 19;2:213. doi: 10.1186/1752-1947-2-213.
Kaposi's sarcoma is a vascular neoplasm mainly affecting the skin of the lower extremities. Although it is the most common neoplasm affecting patients with AIDS, sporadic cases in HIV-negative people have been reported. It is a lesion mainly affecting men and its clinical presentation presents a challenge, as it can resemble other benign or malignant skin lesions.
We report a rare case of Kaposi's sarcoma presenting in a 68-year-old Mediterranean woman with no evidence of HIV infection. The patient had a 6-month history of a slowly progressing pigmented lesion on the dorsum of her left hand. The lesion clinically resembled a squamous cell carcinoma. The patient was treated with a wide excision of the lesion and primary reconstruction with a full thickness skin graft. Histopathological and immunohistochemical analysis of the excised lesion revealed the presence of Kaposi's sarcoma. Serologic investigation for HIV was negative but polymerase chain reaction for human herpes virus type 8 infection was positive. Thorough clinical and imaging investigation of the abdomen and chest were both negative for loci of disease.
Kaposi's sarcoma, although rare in its sporadic form, should be considered in the differential diagnosis of indeterminate skin lesions, especially those affecting the extremities.
卡波西肉瘤是一种主要累及下肢皮肤的血管性肿瘤。尽管它是影响艾滋病患者最常见的肿瘤,但也有人类免疫缺陷病毒(HIV)阴性个体的散发病例报道。它是一种主要影响男性的病变,其临床表现具有挑战性,因为它可能类似于其他良性或恶性皮肤病变。
我们报告一例罕见的卡波西肉瘤病例,患者为一名68岁的地中海地区女性,无HIV感染证据。患者左手背有一个缓慢进展的色素沉着病变,病史6个月。该病变临床类似鳞状细胞癌。患者接受了病变广泛切除及全厚皮片一期重建治疗。切除病变的组织病理学和免疫组化分析显示存在卡波西肉瘤。HIV血清学检测为阴性,但人疱疹病毒8型感染的聚合酶链反应为阳性。腹部和胸部的全面临床及影像学检查均未发现病变部位。
卡波西肉瘤虽然散发病例罕见,但在不确定皮肤病变的鉴别诊断中应予以考虑,尤其是那些累及四肢的病变。