Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho, Avenida Cidade de Montgeron, 212 -, 4490-402, Póvoa de Varzim, Portugal.
BMC Cancer. 2018 Jul 3;18(1):708. doi: 10.1186/s12885-018-4611-3.
The purpose of this case report is to describe a conjunctiva and eyelid Kaposi's sarcoma (KS) as the initial manifestation of acquired immunodeficiency syndrome (AIDS), which led to the diagnosis of HIV infection. There are only 3 reported cases of ocular KS as an initial manifestation of HIV infection.
A 32-year old white man presented to our department with a 1 month history of eye redness. The patient had an enlarged violet-coloured mass on the right superior eyelid which had evolved over the course of 1 week. There was also a mobile bulbar conjunctival lesion with a bright red colour, approximately 5 mm × 5 mm, in the superior temporal quadrant of his left eye. The lesions looked like a chalazion and a subconjunctival haemorrhage, respectivly. Presumed KS diagnosis was confirmed with HIV-1 positive testing and histopathology from tissue biopsy. The patient's CD4 count was 23/mm and viral RNA load 427,000/ml. Further systemic evaluation showed a diffuse sarcoma.
This case report demonstrates the importance of recognizing the ocular manifestations of AIDS in establishing the correct diagnosis of KS and subsequently diagnosing occult HIV infection. Although ocular KS as the initial manifestation of HIV-AIDS is an extremely rare event, a proper diagnosis may contribute to prompt management with personal and social relevance.
本病例报告旨在描述以结膜和眼睑卡波西肉瘤（KS）为首发表现的获得性免疫缺陷综合征（AIDS），从而导致 HIV 感染的诊断。仅有 3 例眼部 KS 作为 HIV 感染首发表现的病例报告。
一名 32 岁白人男性因眼红眼痛 1 个月就诊于我科。患者右眼上睑有一个紫红色肿块，大小逐渐增大，历时 1 周。左眼颞上方有一个活动的球结膜病变，呈鲜红色，大小约 5mm×5mm，类似睑板腺囊肿和结膜下出血。经 HIV-1 阳性检测和组织活检的组织病理学检查，确诊为 KS。患者的 CD4 计数为 23/mm，病毒 RNA 载量为 427,000/ml。进一步的全身评估显示弥漫性肉瘤。
本病例报告表明，认识 AIDS 的眼部表现对于正确诊断 KS 并随后诊断隐匿性 HIV 感染非常重要。尽管眼部 KS 作为 HIV-AIDS 的首发表现极为罕见，但正确的诊断可能有助于及时进行治疗，具有个人和社会意义。
