Case reportA rare case of iatrogenic gingival Kaposi’s sarcoma
Introduction
Kaposi’s sarcoma (KS) is a slow-growing endothelial cell tumour that has a higher incidence in transplant patients. Oral mucosal lesions are very rare and may present a diagnostic challenge. To the best of our knowledge, only two cases of gingival KS in renal transplant patients have been reported in the English-language literature (Siegal et al., 1990, Bowie and Bach, 1999). We present a new case of iatrogenic gingival KS which developed in a young patient 5 years after a renal transplant and discuss the histological features and differential diagnosis.
Section snippets
Case report
A 21-year-old woman was referred to an oral maxillofacial surgeon for evaluation of a slow-growing mass over the lingual aspect of the right posterior region of the mandible. The patient had noticed the lesion 4 months earlier. There had been no episodes of infection, pain or suppuration. There had been problems with oral hygiene and bleeding in the region. Physical examination revealed a blue-to-purplish, firm, nodular, ulcerated lesion on lingual attached gingiva in the right mandibular
Discussion
KS is a mesenchymal angioproliferative neoplasm that can affect the skin, mucosa, and internal organs. The lesion is 400–500 times more common among transplant patients than among the general population, afflicting 1 out of 200 transplant patients in the United States (Harwood et al., 1979). In this group of patients, immunosuppressive therapy plays a major role in the development of the lesion (Mitxelena et al., 2003) that is known as iatrogenic KS (Trattner et al., 1993).
Iatrogenic KS
Conclusion
Gingival KS can be easily confused with benign gingival lesions such as reactive or inflammatory lesions. The medical history, the careful histological examination and the use of PCR for the presence of HHV-8 are fundamental to the diagnostis.
Conflict of interest
None.
References (21)
- et al.
The role of surgery and radiotherapy in treatment of soft tissue sarcomas of the head and neck region: review of 30 cases
J Craniomaxillofac Surg
(2009) - et al.
Spindle cells and their role in Kaposi’s sarcoma
Int J Biochem Cell Biol
(2005) - et al.
Kaposi’s sarcoma in recipients of renal transplants
Am J Med
(1979) - et al.
Bartonellosis. New and old
Infect Dis Clin North Am
(2000) Oral pyogenic granuloma: a review of 137 cases
Br J Oral Maxillofac Surg
(2009)- et al.
Pyogenic granuloma: evaluation of oral conditions
Br J Oral Maxillofac Surg
(1986) Histologic features of Kaposi’s sarcoma and simulators of it
- et al.
Oral Kaposi’s sarcoma in a non-AIDS patient
Gen Dent
(1999) - et al.
Bacillary angiomatosis in a renal transplant recipient
Transplantation
(1999) - et al.
Promontory sign in a reactive benign vascular proliferation
Am J Dermatopathol
(2010)