Crosetti Erika, Succo Giovanni
ENT Department, Martini Hospital, Turin, Italy.
J Med Case Rep. 2013 Dec 31;7:293. doi: 10.1186/1752-1947-7-293.
Kaposi's sarcoma is a malignant, slowly progressing, mesenchymal neoplasm characterized by a proliferation of connective tissue and capillaries. Clinical presentation is usually as nodules and red-purple plaques. This case report not only represents an uncommon presentation of Kaposi's sarcoma in a non-immunocompromised patient, but also supports the role of viral infection in the pathogenesis of this disease. It provides some interesting information about this rare disease, particularly in patients who are human immunodeficiency virus negative.
A 48-year-old Caucasian man presented with a sensation of a foreign body in his throat, accompanied by stomatolalia. Maxillofacial and neck magnetic resonance imaging confirmed the presence of a voluminous solid mass at the base of his tongue with oropharyngeal space reduction. Histological analysis indicated that the lesion was compatible with ulcerated Kaposi's sarcoma of the oropharynx. Results of serological tests for human immunodeficiency virus infection were negative as was the result of the human herpesvirus-8 test, but the cytomegalovirus test result was positive.
This case is unusual because the patient had only oropharyngeal localization of disease, without evidence of immunosuppression or the typical background or risk factors suggesting the classic or endemic form of Kaposi's sarcoma. Isolated cases of Kaposi's sarcoma with oropharyngeal manifestations not associated with human immunodeficiency virus infection are rare, and only 15 cases have been reported to date. At present, its localization, microscopic and histological characteristics, and patterns of progression are the main tools used for differential diagnosis of Kaposi's sarcoma from other vascular neoplasms.
卡波西肉瘤是一种恶性、进展缓慢的间质性肿瘤,其特征为结缔组织和毛细血管增生。临床表现通常为结节和红紫色斑块。本病例报告不仅展示了卡波西肉瘤在非免疫功能低下患者中不常见的表现,还支持病毒感染在该疾病发病机制中的作用。它提供了有关这种罕见疾病的一些有趣信息,特别是在人类免疫缺陷病毒阴性的患者中。
一名48岁的白种男性因喉咙有异物感并伴有口吃前来就诊。颌面和颈部磁共振成像证实舌根部存在一个巨大的实性肿块,口咽间隙缩小。组织学分析表明,该病变与口咽溃疡性卡波西肉瘤相符。人类免疫缺陷病毒感染的血清学检测结果为阴性,人类疱疹病毒8检测结果也是阴性,但巨细胞病毒检测结果为阳性。
该病例不寻常,因为患者仅口咽部有病变,无免疫抑制证据,也没有提示经典型或地方型卡波西肉瘤的典型背景或危险因素。孤立的口咽部表现且与人类免疫缺陷病毒感染无关的卡波西肉瘤病例很少见,迄今为止仅报道了15例。目前,其定位、微观和组织学特征以及进展模式是用于将卡波西肉瘤与其他血管性肿瘤进行鉴别诊断的主要依据。