Kaposi's sarcoma ❤️ Blog of the MN Dobrobut

Kaposi's sarcoma: causes, symptoms and diagnosis

The first documented description of Kaposi's sarcoma dates back to 1872. In European countries, people in the age range from 50 to 70 years are more prone to the disease, and men get sick 2-3 times more often than the female part of the population.

What is Kaposi's sarcoma

Kaposi's sarcoma is a malignant neoplastic lesion of lymphatic and blood vessels of soft tissues, and in the majority of cases the pathology spreads in the dermis.

Causes and risk factors

It is currently not possible to accurately determine the causes of the disease, but there are clear patterns that increase the likelihood of the disease, such as:

Human herpesvirus type 8 - there is now a body of evidence that this viral disease is the main cause of sarcoma.
Disrupted immune status due to damage to the body by HIV infection.
Some malignant tumors increase the likelihood of Kaposi's sarcoma (myeloma, Hodgkin, and others).
Decrease in immune status during the treatment of a number of diseases with drugs that have an immunosuppressive effect. These are autoimmune diseases, chemoradiation therapy for tumors.

Increased risk of developing the disease in men from areas of central Africa and countries of the Mediterranean basin.

Kaposi's sarcoma: symptoms

The clinic of this disease is quite diverse and can cause many questions even for experienced doctors. Symptoms of Kaposi's sarcoma can be divided into two main groups - local and general.

The local manifestation is characterized by the appearance of components of neoplasia on the skin and mucous membranes. Kaposi's sarcoma of the skin manifests itself in various ways:

spots of various colors, from pink to brown: can be located in the most diverse areas of the body: Kaposi's sarcoma on the legs, arms, etc.
knots of different shapes and sizes;
tumors of nodular type.

Basically, the elements are located on the skin, in particular, cancer likes to affect the lower limbs (feet), the back of the hands, but it can appear anywhere. Kaposi's sarcoma in the mouth and other mucous membranes occurs much less often. As the disease progresses, the number of elements of neoplasia can number in the hundreds.

General manifestations are non-specific, appear relatively rarely. Their list can include:

Paraesthesia is one of the main manifestations. Patients complain of various sensations in the places of development: tingling, a feeling of unbearable heat or cold, tingling. The temperature form of paresthesia brings the greatest discomfort.
Pains - can be very diverse, from pricking to shooting, short-term and constant;
Severe itching, aching, burning of damaged skin areas.

Kaposhi's disease: stages of the disease

Kaposi's sarcoma is divided into several typical stages.

Spotted. The initial stage, manifested by red spots with a bluish or dark brown (brown) shade and a smooth surface. Their diameter varies from 1 to 5 cm, individual elements can merge into large spots. The main location is the hands and feet. Subjectively, they may not manifest at all or have minimal symptoms (slight itching, tingling, etc.).
Papular. It is characterized by the appearance of papules - nodules, rammers in the range from 2 to 10 mm, which have the shape of a sphere or hemisphere. They are located alone, or grouped in clusters that have the shape of arcs, rings. Color - from pink to red with a brownish shade. Also, occasionally, a plaque with a bumpy or flat surface can form from the spot. Corneal or papillomatous growths may be observed on the surface.
Neoplastic - a severe stage, accompanied by the appearance of tumor nodes. They are soft or dense, up to 50 mm, on both sides there may be bluish or brown shades. The number — from single to powerful distribution, to counting in the hundreds. They can merge into large lumpy neoplasms. The surface can be covered with sores or foul-smelling secretions. Over time, it can penetrate deep into the tissues, up to the bones, which it also affects.

Forms of cancer

Kaposi's sarcoma is usually divided into 4 clinical types.

Idiopathic — develops in Europeans and residents of the CIS countries, mainly in men over 50 years old. It is characterized by damage to the skin of the feet and hands. Rashes are often preceded by lymphostasis of the extremities, which is manifested by edema and swelling in the lesions, the skin in these places is usually bluish. Lymph nodes can be involved in the process, the defeat is inflammatory in nature. Over time, Kaposi's sarcoma can form in the oral cavity, eyes, underlying soft tissues, internal organs, etc.
Immunosuppressive - occurs against the background of therapy of diseases in which it is necessary to take drugs that suppress immunity. Most often, this is a transplant of internal organs or treatment of systemic autoimmune pathologies of the body. The disease is more aggressive than the idiopathic form, often accompanied by large lesions of the skin, soft tissues, lymph nodes, and internal organs. If the dosage of the provoking drug is reduced, the disease may regress.
Endemic - affects people prone to this cancer who live in the central regions of Africa. It manifests itself in several forms: nodular - the appearance of plaques and nodular tumors on the skin; blooming - mushroom-shaped cells predominate, a more aggressive option; infiltrative - manifested by a very pronounced penetration of the tumor into the soft tissues, up to bone damage; lymphadenopathic - penetrates into the lymph nodes and quickly spreads to the organs of the abdominal cavity. Kaposi's nodular sarcoma is more favorable, the prognosis for the infiltrative type is worse than for other subtypes.
AIDS-associated - the most common type of Kaposi's syndrome. Features - development occurs in an earlier age range, on average starting from 37 years. It appears in the predominant number of cases on the skin, in the form of small spots of blue-blue or pink shades. It actively affects the hard palate, nose and upper limbs, while the lower ones, on the contrary, are rarely affected by cancer. Often, tumor centers are located in the organs of the abdominal cavity (up to 75% of cases).

By severity, the following are distinguished:

Guest defected. It is manifested by a bright and stormy beginning, rapid spread of neoplastic processes over the entire area of the skin, pronounced and progressive symptoms of general exhaustion. Cancer quickly affects internal organs, often with an unfavorable result.
Undercurrent. It has less pronounced clinical manifestations, tumor growth progresses somewhat more slowly.
Chronic course is a relatively favorable option, the progression of symptoms can be manifested for tens of years.

Complications of Kaposi's sarcoma

There are several complications of the disease:

Various skin bruises - ecchymoses, purpura and others.
Swelling of the affected limb due to impaired outflow of lymphoid fluid. At the same time, the size of the leg/hand can increase significantly (by 1.5-2 times), over time the development of elephantiasis is possible. It is believed that the outflow is disturbed due to tumor compression of lymphatic vessels and veins, or neoplasia processes in the vessels themselves.
Spreading elements of the neoplasm on soft tissues, mucous membranes, in particular the upper respiratory tract, eyes and oral cavity. This can lead to corresponding symptoms in the affected structures.
The defeat of the lymph nodes is a rather rare sign, in the majority of cases it has an inflammatory nature. However, the manifestation of this complication refers to prognostically unfavorable factors of the course of the disease.
Internal organs are affected by tumor in 20% of cases, often have an asymptomatic course.

Diagnosis of the disease

Diagnostic measures in determining the disease are based on clinical data. However, in difficult cases, some additional research methods can be used:

diagnostic manipulations to detect HIV — the disease in a large number of cases occurs together with this type of cancer;
blood examination for the determination of human herpesvirus type 8;
examination of tissue samples to verify the diagnosis using histological methods;
use of diagnostic imaging methods to determine the extent of cancer foci: ultrasound screening, magnetic resonance imaging.

Treatment of Kaposi's sarcoma

Treatment is carried out with the help of several components:

Chemotherapy drugs - have different mechanisms of action, aimed at inhibiting the growth of neoplasia. A large number of complications is dangerous, but it is often the only effective method of oncology therapy.
Treatment of HIV (if diagnosed) to improve the patient's immune status.
Selection of the correct doses of immunosuppressants in the immunosuppressive variant of Kaposi's sarcoma.
Local treatment — directed radiation therapy, cryosurgery, various ointments, applications, local injections.

Prevention of Kaposi's sarcoma

Cancer prevention cannot guarantee its complete prevention, however, it significantly reduces the probability of pathology. Are important:

timely medical examinations;
correct choice of immunosuppressive drugs in the treatment of certain pathologies;
prevention of HIV infection;
in the presence of suspicious symptoms (characteristic skin lesions, general signs) — visit a specialized specialist.

It is important to remember that when diagnosing Kaposi's sarcoma, the initial stage has the greatest tendency for a favorable outcome. The earlier the consultation with an oncologist is carried out, the higher the chances. Take care of your health and engage in timely disease prevention.