Oral Kaposi's Sarcoma: A Case Report and Literature Review on Treatment Management. (16th October 2021)

• Record Type: Journal Article
• Authors: Thieringer, Florian M.; Cede, Julia; Glatz, Katharina; Roehling, Stefan; Stoeckle, Marcel; Leiggener, Christoph S.
• Is Part Of: Craniomaxillofacial trauma & reconstruction open. Volume 6(2021)
• Publication Date: 2021-10-16
• Subjects: Kaposi's sarcoma -- oral Kaposi's sarcoma -- combined antiretroviral therapy -- cART -- HIV infection -- HHV8-infection; Face -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Head -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.51
• DOI: 10.1177/24727512211036328
• Languages: English
• ISSNs: 2472-7512

Abstract

Background: Kaposi's sarcoma is a common malignancy in HIV patients. Oral manifestation of AIDS-associated Kaposi's sarcoma occurs in up to 65% of HIV/AIDS patients and is a poor prognostic factor. We report the case of a patient with a progressive bulky manifestation of oral Kaposi's sarcoma. Case Presentation: A 48-year-old male presented with dysphagia due to progressive indolent swelling of the palate. Intraoral inspection revealed an uneven, partially ulcerated, livid mass, approximately 5 cm in diameter, extending antero-posteriorly from the superior vestibulum to the soft palate and across the hard palate, thereby overgrowing remaining teeth and the alveolar arch. Serological testing revealed an HIV infection, and further tests showed HHV8-positivity. The patient underwent surgical debulking of the oral lesions and, following complete remission, received full mouth reconstruction with an implant-supported prosthesis. Conclusions: Understanding the relation of HIV and HHV8-infection in terms of disease onset and clinical presentation is important to increase awareness of oral Kaposi's sarcoma and ensure subsequent appropriate management of affected patients. Clinical staging represents the most important factor for choosing the optimal treatment. The introduction of combined antiretroviral therapy has proven to be efficient in curing oral Kaposi's sarcoma, while several additional locoregional treatment options, including debulking surgery, may be necessary for symptom relief or to improve cosmesis. Radiotherapy should be applied restrictively due to potentially severe toxic mucosal reactions, whereas additional chemotherapy must be considered in severe cases that present with widespread disseminated disease. A multidisciplinary approach to the treatment of functionally and aesthetically impairing oral Kaposi's sarcoma is highly recommended.