Aggressive classic Kaposi’s sarcoma: case report

Abstract

ve neoplasm associated with human herpesvirus type 8 (HHV-8). The classic form affects elderly men, presenting with purpuric papules and nodules on the lower limbs, with a slow evolution, usually without the need for specific treatment. Objective To report a case of neoplasm of aggressive behavior in the elderly. Methods A descriptive study of the case report type was carried out, based on the collection of data from medical records, photographic records and literature review. Case report An 86-year-old man presented with brownish and violet papules on the upper limbs, diffuse purplish papules and nodules in the right lower limb, some with a verruciform appearance and purplish papules and nodules on the thigh and posterior region of the left leg. Upper digestive endoscopy showed lesions suggestive of Kaposi’s Sarcoma in the duodenum. Immunohistochemistry was positive for CD31, CD34 and HHV-8. The patient presented multiple clinical and laboratory decompensations, which culminated in his death. No specific therapy had been initiated. Discussion Classical KS is rare, indolent, and more common in men aged 64 to 72 years, of South American, Mediterranean, or Eastern European Jewish descent. HHV-8 infection, extremely prevalent in our country, has been considered the most important risk factor. The evolution of this malignancy is slow, but the progress of the lesions can be variable, with progression and spread of the lesions in weeks. Visceral involvement, as in the case reported, occurs in less than 10% of cases. In general, KS has a good response to different therapies. Conclusion It is imperative that the diagnosis of classic Kaposi’s Sarcoma be considered in the face of an aggressive condition, especially in elderly men.