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Oral lymphangioma-like Kaposi sarcoma: a Brazilian case report in a scenario of a still high number of HIV infections

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Abstract

We present a challenging case of HIV-related lymphangioma-like Kaposi sarcoma (LLKS) affecting the oral cavity. A 54-year-old Brazilian male patient was referred to our center complaining of bleeding lesions affecting the oral cavity for 2 months. Interestingly, these oral lesions were the first clinical manifestation of HIV infection. Clinically, multiple erythematous nodular and patch lesions were observed. An incisional biopsy was performed, revealing numerous microscopic angled and irregular vascular channels lined with flattened endothelial cells. More cellularized and solid areas consisting of more fusiform cells with little pleomorphism and with slit-like vascular channels were noted. Based on immunoreactivity for CD31, CD34, D2-40, and HHV-8, the final diagnosis was oral LLKS. Highly active antiretroviral therapy (HAART) was initiated with dolutegravir, tenofovir, and lamivudine. During follow-up, the patient showed KS metastases to other sites and a chemotherapeutic protocol was initiated. Regression of the oral lesion was clearly noted by the clinicians 1 year after the KS diagnosis. Dentists should be able to recognize systemic diseases that affect the oral cavity such as KS in order to make an early diagnosis of its oral manifestations and to implement effective therapeutic measures to ensure a better prognosis.

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Acknowledgements

This study was supported by the Coordination of Improvement of Higher Education Personnel (CAPES, Finance Code 001), Brazil. L.F.S. is the recipient of fellowships. We would like to thank the Brazilian National Council for Scientific and Technological Development for financial support (CNPq). M.D.M. and P.A.V. are research fellows of CNPq. The authors are also grateful to the São Paulo State Research Foundation (FAPESP 2016/21785-4) for a student scholarship.

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Authors and Affiliations

  1. Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, Areão, Piracicaba, São Paulo, Brazil

    Lauren Frenzel Schuch, Amanda Almeida Leite, Pablo Agustin Vargas & Manoela Domingues Martins

  2. Department of Oral Pathology, School of Dentistry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil

    Luan Nathiel Santana Kovalski, Vinícius Coelho Carrard, Marco Antonio Trevizani Martins & Manoela Domingues Martins

  3. Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Vinícius Coelho Carrard & Marco Antonio Trevizani Martins

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  1. Lauren Frenzel Schuch
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  2. Luan Nathiel Santana Kovalski
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  3. Amanda Almeida Leite
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  4. Vinícius Coelho Carrard
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  5. Marco Antonio Trevizani Martins
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  6. Pablo Agustin Vargas
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  7. Manoela Domingues Martins
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Correspondence to Lauren Frenzel Schuch.

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Schuch, L.F., Kovalski, L.N.S., Leite, A.A. et al. Oral lymphangioma-like Kaposi sarcoma: a Brazilian case report in a scenario of a still high number of HIV infections. Oral Maxillofac Surg 26, 171–176 (2022). https://doi.org/10.1007/s10006-021-00974-8

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