Yang Jing, Yin Xiao-Fang, Li Yong-Ping, Zhou Shi-You
The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center at Sun Yat-sen University, #54 Xian lie South Road, Guangzhou, 510060, China.
BMC Ophthalmol. 2017 Aug 14;17(1):143. doi: 10.1186/s12886-017-0525-0.
Kaposi's sarcoma (KS) is generally considered a neoplastic disorder of vascular origin and occurs in patients with acquired immunodeficiency syndrome (AIDS) or who have received immunosuppressive treatments after an organ transplant (Soulier et al., Blood 86(4):1276-80, 1995; Viejo-Borbolla and Schulz, AIDS Rev 5(4):222-9, 2003; Schulz, J Antimicrob Chemother 45(Suppl T3):15-27, 2000; Aversa et al. Crit Rev Oncol Hematol 53(3):253-65, 2005; Mbulaiteye and Engels, Int J Cancer 119(11):2685-91, 2006; Tessari et al., Eur J Dermatol 16(5):553-7, 2006). Several Kaposi's sarcoma case reports involving eyelids and conjunctiva have been published (Bavishi et al., Int J STD AIDS 23(3):221-2, 2012; Baumann et al., Ger J Ophthalmol 4(4):239-45, 1995).
we report a 13 years old asian male patient rare case of ocular KS that was initiated from the sclera and progressed into the cornea and conjunctiva without an human Immunodeificiency Virus (HIV) or HHV-8 infection after a peripheral blood stem cells transplantation. In this case, anti- vascular endothelial growth factor (VEGF) therapy was attempted to stop the advance of ocular lesions and failed. Eventually, the KS was cured by a limbo-corneal lamellar graft, an amniotic membrane and scleral allograft transplantation plus intraoperative mitomycin C(MMC) after the complete excision of the tumors.
A compete surgical excision combined with the intraoperative application of MMC, as well as grafts to repair the scleral, conjunctival, and corneal surfaces, could prevent a recurrence of KS.
卡波西肉瘤(KS)一般被认为是一种血管源性肿瘤性疾病,发生于获得性免疫缺陷综合征(AIDS)患者或器官移植后接受免疫抑制治疗的患者(苏利耶等人,《血液》86(4):1276 - 80,1995;维耶霍 - 博尔博拉和舒尔茨,《艾滋病综述》5(4):222 - 9,2003;舒尔茨,《抗菌化疗杂志》45(增刊T3):15 - 27,2000;阿韦萨等人,《肿瘤学与血液学评论》53(3):253 - 65,2005;姆布莱泰耶和恩格斯,《国际癌症杂志》119(11):2685 - 91,2006;泰萨里等人,《欧洲皮肤病学杂志》16(5):553 - 7,2006)。已有多篇关于累及眼睑和结膜的卡波西肉瘤病例报告发表(巴维希等人,《国际性传播疾病与艾滋病杂志》23(3):221 - 2,2012;鲍曼等人,《德国眼科杂志》4(4):239 - 45,1995)。
我们报告一例13岁亚洲男性患者罕见的眼部卡波西肉瘤病例,该病例起源于巩膜,在未感染人类免疫缺陷病毒(HIV)或HHV - 8的情况下,外周血干细胞移植后进展至角膜和结膜。在此病例中,尝试使用抗血管内皮生长因子(VEGF)疗法阻止眼部病变进展,但失败了。最终,在肿瘤完全切除后,通过板层角膜移植、羊膜和巩膜同种异体移植联合术中丝裂霉素C(MMC)治愈了卡波西肉瘤。
完整的手术切除联合术中应用MMC,以及用于修复巩膜、结膜和角膜表面的移植手术,可预防卡波西肉瘤复发。