Torrence Garneisha M, Wrobel James S
Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms, University of Michigan Hospital and Health Systems, (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
Clin Diabetes Endocrinol. 2019 Jul 8;5:8. doi: 10.1186/s40842-019-0083-x. eCollection 2019.
The presentation of Kaposi sarcoma is divided into four known clinical subtypes. In this case report we describe classic Kaposi sarcoma in an African-American heterosexual, diabetic, seronegative human immunodeficiency virus male. Classic Kaposi sarcoma is rare in this patient demographic and can be easily misdiagnosed.
The patient presented with a lesion between the fourth and fifth digits of his right foot which was initially diagnosed as a diabetic foot ulcer. Despite local wound care, the lesion did not resolve. A shave biopsy was performed and histopathology findings were consistent with classic Kaposi sarcoma.
The patient tolerated local radiotherapy well and had complete resolution of his pedal lesion. There have been emerging associations between diabetes and Kaposi sarcoma. As such, clinicians should have a low threshold when considering the biopsy of suspicious pedal lesions in patients with diabetes. The utilization of appropriate biopsy technique may lead to the diagnosis of classic KS tumors in populations outside of the current four widely accepted clinical subtypes.
卡波西肉瘤的表现分为四种已知的临床亚型。在本病例报告中，我们描述了一名非裔美国异性恋、患有糖尿病且血清学阴性的男性人类免疫缺陷病毒感染者的经典型卡波西肉瘤。经典型卡波西肉瘤在该患者群体中较为罕见，且容易被误诊。
患者右足第四和第五趾间出现一处病变，最初被诊断为糖尿病足溃疡。尽管进行了局部伤口护理，病变仍未愈合。进行了削切活检，组织病理学结果与经典型卡波西肉瘤一致。
患者对局部放疗耐受性良好，足部病变完全消退。糖尿病与卡波西肉瘤之间的关联日益显现。因此，临床医生在考虑对糖尿病患者可疑的足部病变进行活检时应保持较低的阈值。采用适当的活检技术可能会在目前四种广泛认可的临床亚型之外的人群中诊断出经典型卡波西肉瘤肿瘤。
