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播散性卡波西肉瘤伴眼部受累:一例罕见的多系统病例报告

Disseminated Kaposi Sarcoma With Ocular Involvement: An Unusual Multisystem Case Presentation.

作者信息

Torralbas Fitz Ana de Lourdes, Cruzata Matos Idania Maria, Torralbas Fitz Sergio Jose, Leon Figueredo Eliany, Blanco Espinosa Elizabeth

机构信息

Oncology, Maputo Central Hospital, Maputo, MOZ.

General Medicine, Facultad de Ciencias Medicas, Holguin, CUB.

出版信息

Cureus. 2025 Aug 14;17(8):e90070. doi: 10.7759/cureus.90070. eCollection 2025 Aug.

DOI:10.7759/cureus.90070
PMID:40922874
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12414533/
Abstract

Kaposi sarcoma (KS) is an angioproliferative malignancy associated with human herpesvirus 8 (HHV-8) infection, predominantly affecting immunocompromised patients such as those with HIV/AIDS. Despite advances in antiretroviral therapy, KS remains a significant cause of morbidity and mortality in this population, especially when diagnosis or treatment is delayed. Ocular involvement, although rare, can lead to significant functional impairment. We report the case of a 21-year-old HIV-positive female on antiretroviral therapy who presented with extensive cutaneous lesions, facial infiltration, periorbital edema causing visual obstruction, and cervical lymphadenopathy. Histopathologic examination confirmed nodular-stage KS. The patient was staged as T1 I1 S1 according to the AIDS Clinical Trials Group (ACTG) classification, indicating advanced disease. Treatment included continuation of antiretroviral therapy, blood transfusions, and systemic chemotherapy with liposomal doxorubicin. After four cycles, she achieved complete clinical and immunologic remission, with resolution of lesions and restoration of visual function. This case highlights the critical role of early recognition, histopathologic diagnosis, and multidisciplinary management in HIV-associated KS. It also underscores the potential for favorable outcomes with timely and integrated therapy, even in advanced cases with ocular involvement.

摘要

卡波西肉瘤(KS)是一种与人类疱疹病毒8型(HHV-8)感染相关的血管增殖性恶性肿瘤,主要影响免疫功能低下的患者,如艾滋病毒/艾滋病患者。尽管抗逆转录病毒疗法取得了进展,但KS仍然是该人群发病和死亡的重要原因,尤其是在诊断或治疗延迟时。眼部受累虽然罕见,但可导致严重的功能障碍。我们报告了一例21岁接受抗逆转录病毒治疗的艾滋病毒阳性女性病例,该患者出现广泛的皮肤病变、面部浸润、导致视力障碍的眶周水肿和颈部淋巴结病。组织病理学检查确诊为结节期KS。根据艾滋病临床试验组(ACTG)分类,该患者分期为T1 I1 S1,表明疾病已进展。治疗包括继续抗逆转录病毒治疗、输血以及使用脂质体阿霉素进行全身化疗。四个周期后,她实现了完全的临床和免疫缓解,病变消退,视力功能恢复。该病例突出了早期识别、组织病理学诊断和多学科管理在艾滋病毒相关KS中的关键作用。它还强调了即使在伴有眼部受累的晚期病例中,及时和综合治疗也可能取得良好结果的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/bb4d4c985b8e/cureus-0017-00000090070-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/c7ef944c5616/cureus-0017-00000090070-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/b089f5b2d33e/cureus-0017-00000090070-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/bb4d4c985b8e/cureus-0017-00000090070-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/c7ef944c5616/cureus-0017-00000090070-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/b089f5b2d33e/cureus-0017-00000090070-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614e/12414533/bb4d4c985b8e/cureus-0017-00000090070-i03.jpg

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本文引用的文献

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A Retrospective Study on the Incidence of Kaposi Sarcoma in the United States From 1999 to 2020 Using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) Database.一项利用疾病控制与预防中心广泛在线流行病学研究数据(CDC WONDER)数据库对1999年至2020年美国卡波西肉瘤发病率进行的回顾性研究。
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Immune Checkpoint Inhibitors in the Treatment of Ocular Surface Cancers: A Review.免疫检查点抑制剂在眼表癌治疗中的应用综述
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Regression of Clinically Diagnosed Ocular Kaposi Sarcoma Post-Initiation of Highly Active Antiretroviral Therapy.
高效抗逆转录病毒治疗开始后临床诊断的眼部卡波西肉瘤的消退
Am J Trop Med Hyg. 2024 Dec 24;112(3):682-684. doi: 10.4269/ajtmh.24-0584. Print 2025 Mar 5.
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Atypical presentation of Kaposi sarcoma in an HIV-negative patient: a case report and comprehensive literature review.一名HIV阴性患者的卡波西肉瘤非典型表现:病例报告及文献综述
Ann Med Surg (Lond). 2024 Sep 30;86(12):7325-7329. doi: 10.1097/MS9.0000000000002553. eCollection 2024 Dec.
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Management and Future Therapeutic Perspectives of Classic Kaposi's Sarcoma: An Evidence-Based Review.经典型卡波西肉瘤的管理与未来治疗前景:一项基于证据的综述
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Burden of Kaposi sarcoma according to HIV status: A systematic review and global analysis.根据 HIV 感染状况评估卡波西肉瘤负担:系统评价和全球分析。
Int J Cancer. 2022 Jun 15;150(12):1948-1957. doi: 10.1002/ijc.33951. Epub 2022 Feb 16.
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