Kaposi’s sarcoma
Initially, Kaposi’s sarcoma, a cancer of vascular and lymphatic endothelial cell origin, was described as a rare sarcoma occurring mostly in elderly Italian and Jewish males. In recent years, the incidence of Kaposi’s sarcoma has risen dramatically along with the incidence of acquired immunodeficiency syndrome (AIDS). Currently, it’s the most common AIDS-related cancer.
Characterized by obvious, colorful lesions, Kaposi’s sarcoma causes structural and functional damage. When associated with AIDS, it progresses aggressively, involving the lymph nodes, the viscera, and possibly GI structures.
Causes
The exact cause of Kaposi’s sarcoma is unknown, but the disease is related to immunosuppression. Genetic or hereditary predisposition is also suspected.
Complications
Disease progression can cause severe pulmonary involvement, resulting in respiratory distress, and GI involvement, leading to digestive problems.
Assessment
The health history typically reveals that the patient has AIDS. If the sarcoma advances beyond the early stages or if a lesion breaks down, the patient may report pain and itching. Usually, however, the lesions remain painless unless they impinge on nerves or organs.
On inspection, you may observe several lesions in various shapes, sizes, and colors (ranging from red-brown to dark purple). Initially, lesions may begin on the lower legs, such as the ankle and foot area, then metastasize to areas on the upper body (hands and forearm), then advance to the buccal mucosa areas. The lesions occur most commonly on the skin, buccal mucosa, hard and soft palates, lips, gums, tongue, tonsils, conjunctiva, and sclera. In advanced disease, the lesions may join, becoming one large plaque. Untreated lesions may appear as large, ulcerative masses. You may notice that the patient has dyspnea, especially if pulmonary involvement occurs.
Palpation and inspection may also disclose edema from lymphatic obstruction.
Auscultation may uncover wheezing and hypoventilation. The most common extracutaneous sites are the lungs and GI tract (including the esophagus, oropharynx, and epiglottis).
Diagnostic tests
Usually, the patient will undergo a tissue biopsy to determine the lesion’s type and stage. Then, a computed tomography scan may be performed to evaluate metastasis.
