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Kaposi Sarcoma of the Penis

Definition:

Kaposi sarcoma is a malignant tumor of the reticuloendothelial system caused by HHV8 (human herpesvirus 8) with formation of cutaneous tumors and risk of spreading (Antman et al., 2000):

• Classical Kaposi sarcoma: without immunodeficiency, first described in older patients of Mediterranean heritage.
• Endemic Kaposi sarcoma: in Afrika due to immune defects caused by malaria, chronic infections, or malnutrition.
• Epidemic Kaposi sarcoma: in patients with AIDS. The tumor is also AIDS-defining; see section HIV and AIDS.
• Iatrogenic Kaposi sarcoma: under immunosuppressive therapy.

Epidemiology:

2–3% of men with AIDS are diagnosed with a genital Kaposi lesion. Without AIDS, Kaposi sarcoma is a sporadic tumor.

Etiology:

The combination of immunodeficiency with an oncogenic virus (HHV-8) causes malignant transformation of lymphatic tissue. The transmission of the virus via sexual intercourse causes a high incidence of Kaposi sarcoma in homosexual AIDS patients (as opposed to drug addicts or hemophilia patients with AIDS). However, immunodeficiency is not obligatory (Micali et al., 2003).

Signs and Symptoms

Purplish to brown maculopapular lesions, confluent. Lymphedema.

Diagnosis:

Serological tests for HHV-8 and HIV infection, biopsy of a lesion.

Treatment of Kaposi Sarcoma

Local Therapy:

Local therapy is often an option in the genital area: injection of chemotherapy, radiation therapy, or laser coagulation.

Medical Therapy:

Optimization of antiretroviral therapy.

Palliative therapy:

If local and medical therapy fails, urinary retention requires a transurethral or suprapubic catheter.

References

Antman und Chang 2000 ANTMAN, K. ; CHANG, Y.: Kaposi’s sarcoma.
In: N Engl J Med
342 (2000), Nr. 14, S. 1027–38

Micali u.a. 2003 MICALI, G. ; NASCA, M. R. ; DE PASQUALE, R. ; INNOCENZI, D.: Primary classic Kaposi’s sarcoma of the penis: report of a case and review.
In: J Eur Acad Dermatol Venereol
17 (2003), Nr. 3, S. 320–3

Swierzewski u.a. 1993 SWIERZEWSKI, 3rd ; WAN, J. ; BOFFINI, A. ; FAERBER, G. J.: The management of meatal obstruction due to Kaposi’s sarcoma of the glans penis.
In: J Urol
150 (1993), Nr. 1, S. 193–5

  Deutsche Version: Kaposi Sarkom des Penis