Ozmen Hamid, Baba Dursun, Kacagan Coskun, Kayikci Ali, Cam Kamil
Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
Int J Surg Case Rep. 2014;5(12):1086-7. doi: 10.1016/j.ijscr.2014.11.019. Epub 2014 Nov 13.
Kaposi's sarcoma (KS) is a rare angioproliferative disorder of the vascular endothelium. The development of KS requires Human Herpes Virus 8 (HHV-8) infection. An associated HIV infection is usually seen. Isolated scrotal KS has rarely been reported. In this article, we present a case of KS that primarily involved the scrotum in a HIV negative patient.
A 71-year old male patient admitted to the outpatient department due to nodular lesions on the scrotum. The patient declared that these lesions were present for nearly 5 years. Past medical history revealed that he underwent left thoracotomy and upper lobectomy in 2006 for adenosquamous lung carcinoma. Then, he received a single cycle of adjuvant chemotherapy consisted of docetaxel and cisplatin. Physical examination revealed 3 black small nodules on the scrotum. The anti-HIV test was negative. All scrotal lesions were surgically excised. The pathological investigation revealed KS of the lymphangioma-like type.
The pathogenesis of KS has still not been clearly elucidated. However, it is known that all forms of KS are associated with HHV-8 infections. A defect in immune system was almost always necessary. Therefore, KS is usually associated with HIV infection. KS of the penis has been reported in HIV negative patients. Very few cases of scrotal KS have been presented. In a recent review, only 1 patient had scrotal KS out of 32 cases with HIV negative KS. In our case, the patient received a cycle of chemotherapy that might affect his immune system. The lymphangioma-like type is a common morphological sub-type. While lymph edemas are commonly observed in this sub-type, no edema in the lymphs was present in our case.
Classical KS is generally observed in the lower extremities, it can rarely affect scrotal skin as isolated lesions. Therefore, a careful physical examination should also include scrotum for these patients.
卡波西肉瘤（KS）是一种罕见的血管内皮细胞血管增生性疾病。KS的发生需要人类疱疹病毒8型（HHV-8）感染。通常会伴有HIV感染。孤立性阴囊KS鲜有报道。在本文中，我们报告一例主要累及阴囊的KS病例，该患者为HIV阴性。
一名71岁男性患者因阴囊出现结节性病变入住门诊。患者称这些病变已存在近5年。既往病史显示，他于2006年因腺鳞癌接受了左胸切开术和上叶切除术。然后，他接受了由多西他赛和顺铂组成的单周期辅助化疗。体格检查发现阴囊有3个黑色小结节。抗HIV检测为阴性。所有阴囊病变均通过手术切除。病理检查显示为淋巴管瘤样型KS。
KS的发病机制尚未完全阐明。然而，已知所有形式的KS都与HHV-8感染有关。免疫系统缺陷几乎总是必要的。因此，KS通常与HIV感染有关。有报道称HIV阴性患者会出现阴茎KS。阴囊KS的病例非常少。在最近的一篇综述中，32例HIV阴性KS患者中只有1例有阴囊KS。在我们的病例中，患者接受了一个周期的化疗，这可能影响了他的免疫系统。淋巴管瘤样型是一种常见的形态学亚型。虽然该亚型中常见淋巴水肿，但我们的病例中未出现淋巴水肿。
经典KS一般见于下肢，很少作为孤立病变累及阴囊皮肤。因此，对于这些患者，仔细的体格检查也应包括阴囊。
