Myasthenia gravis developing in an HIV-negative patient with Kaposi's sarcoma.

Sept 2012

Mantero V, Mascolo M, Bandettini di Poggio M, Caponnetto C, Pardini M.

Source

Department of Neurosciences, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162, Milan, Italy, vittorio.mantero@ospedaleniguarda.it.

Abstract

Myasthenia gravis is a disorder of neuromuscular transmission caused by autoimmune mechanisms. We reported a possible association between seropositive myasthenia gravis and Kaposi's sarcoma in a HIV-negative subject and the observed interactions between the treatment regimen for these two conditions. A 62-year-old man came to our attention for ocular myasthenia gravis. He suffered from a classic form of Kaposi's sarcoma since about 1 year. When myasthenic symptoms worsened, the patient was started on prednisone and azathioprine. The patient had a significant worsening of Kaposi's sarcoma, so prednisone and azathioprine were reduced and he was treated with vinblastine, with improvement both in dermatologic than in neurological symptomatology. We propose some considerations: the potential correlation betweenKaposi's sarcoma and myasthenia gravis through immunological mechanism; myasthenia gravis as a paraneoplastic manifestation of Kaposi's sarcoma, and the role of an antitumoral agent as a treatment for both the conditions.

Springerlink

Non-HIV Kaposi's sarcoma: a review and therapeutic perspectives.

Sept 2012

Akasbi Y, Awada A, Arifi S, Mellas N, El Mesbahi O.

Source

Hassan II University Hospital, Medical Oncology Department, 19, rue Jebel Zalagh 2 Narjiss C, 30000 Fez, Morocco, University Libre of Brussels, Institut Jules-Bordet, Medical Oncology Clinic, Brussels, Belgium.

Abstract

"Classic" Kaposi's sarcoma (CKS) not related to HIV is a multifocal angioproliferative neoplasm that is linked to human herpesvirus. CKS is a cutaneous cancer frequently occurring with an indolent course. However, it can compromise the quality of life by causing pain, disfigurement and functional disability. For this reason, the main treatment goals are not only to reduce the cutaneous lesions but also to alleviate organ involvement and psychological stress by delaying disease progression and ultimately cure. This report summarizes systemic treatment options of CKS, including chemotherapy, immunotherapy and anti-HHV8 therapy. In addition, this review will focus on the recent understanding of carcinogenesis and consequently highlight potential "targeted" therapeutic interventions.

John Libbey Eurotext

Instigation of Notch signaling in the pathogenesis of Kaposi's sarcoma-associated herpesvirus and other human tumor viruses.

Oct 2012

Cheng F, Pekkonen P, Ojala PM.

Source

Institute of Biotechnology & Research Programs Unit, Genome-Scale Biology, University of Helsinki, PO Box 56 (Viikinkaari 9), 00014 University of Helsinki, Helsinki, Finland.

Abstract

The Notch pathway is a highly conserved signaling circuit with a critical role in cell-fate determination and tumor initiation. Notch is reported to regulate various key events in tumor progression, such as angiogenesis, maintenance of cancer stem cells, resistance to therapeutic agents and metastasis. This review describes the intimate interplay of human tumor viruses with the Notch signaling pathway. Special attention is paid to Kaposi's sarcoma-associated herpesvirus, the etiological agent of Kaposi's sarcoma and rare lymphoproliferative disorders. The past decade of active research has led to significant advances in understanding how Kaposi's sarcoma-associated herpesvirus exploits the Notch pathway to regulate its replication phase and to modulate the host cellular microenvironment to make it more favorable for viral persistence and spreading.

Future Medicine

Dermoscopic Rainbow Pattern in Kaposi's Sarcoma Lesions: Our Experience

Oct 2012

Rosanna Satta, MD; Leonardo Fresi, MD; Francesca Cottoni, PhD

Arch Dermatol. 2012;148(10):1207-1208. doi:10.1001/archdermatol.2012.2204.

Cheng et al were the first to define the multicolored areas in some Kaposi's sarcoma (KS) lesions observed under polarized-light dermoscopy as rainbow pattern and to describe this dermoscopic feature as specific but not sensitive for the diagnosis of KS. Their observation prompted several interesting discussions in the dermoscopic literature. In our clinical practice, we have observed a high number of classic KS (CKS) cases. Dermoscopic examination of all the KS lesions in a group of patients with CKS was performed to evaluate the sensitivity of the rainbow pattern feature observed in the different clinical types of KS lesions.

Archives of Dermatology

Sarcomas other than Kaposi sarcoma occurring in immunodeficiency: interpretations from a systematic literature review.

Sept 2012

Bhatia K, Shiels MS, Berg A, Engels EA.

Source

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA. bhatiak@mail.nih.gov

Abstract

PURPOSE OF REVIEW:

In immunodeficiency, an increased sarcoma risk is confirmed for Kaposi's sarcoma. Whether rates of other sarcoma subtypes are elevated in the setting of immunodeficiency is not known. We therefore reviewed published case reports on HIV and AIDS patients and organ transplant recipients with sarcomas. For comparison, we assessed sarcomas in the U.S. general population using Surveillance Epidemiology End Results (SEER) data.

RECENT FINDINGS:

A total of 176 non-Kaposi sarcoma were identified, 75 in people with HIV and AIDS and 101 in transplant recipients. Leiomyosarcomas (n = 101) were the most frequently reported sarcomas, followed by angiosarcomas (n = 23) and fibrohistiocytic tumors (n = 17). Leiomyosarcomas were reported with two age peaks, in children and young adults. Epstein-Barr virus (EBV) was detected in the tumor cells in 85 and 88% of leiomyosarcomas in HIV-infected people and transplant recipients, respectively. Angiosarcomas and fibrohistiocytic tumors were most frequently reported in men. Among kidney transplant recipients, 20% of sarcomas arose at the site of an arteriovenous fistula. In comparison, leiomyoscarcomas, angiosarcomas, and fibrohistiocytic tumors comprised 16.9, 3.8, and 18.7% of sarcomas in the U.S. general population.

SUMMARY:

Leiomyosarcoma and angiosarcoma may occur disproportionately in immunodeficiency. Leiomyosarcomas appear causatively linked to EBV, whereas angiosarcomas might be correlated with an arteriovenous fistula. Additional studies are necessary to understand the contribution of immunodeficiency to the cause of these sarcomas.

Lippincott, Williams & Wilkins

Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma.

Aug 2012

Onak Kandemir N, Barut F, Dogan Gun B, Solak Tekin N, Hallac Keser S, Oguz Ozdamar S.

Abstract

BACKGROUND: In this study, the clinical and morphological features of vesiculobullous lesions observed inKaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized.

METHODS:

A total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated.

RESULTS:

Vesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed.

CONCLUSIONS:

Our findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474.

Diagnostic Pathology

Vaccine prospect of Kaposi sarcoma-associated herpesvirus.

Aug 2012

Wu TT, Qian J, Ang J, Sun R.

Source

Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, United States. twu@mednet.ucla.edu

Abstract

Infection of Kaposi sarcoma-associated herpesvirus (KSHV) or human herpesvirus-8 (HHV-8) is estimated to account for 34,000 new cancer cases globally. Unlike other herpesviruses, KSHV is not ubiquitous but is highly prevalent in some areas, such as sub-Saharan Africa where Kaposi sarcoma is the leading cancer among adults. While latent infection of KSHV plays a major and direct role in tumorigenesis, viral lytic replication also makes significant contributions to this process. Efforts to develop a KSHV vaccine are limited, but studies with EBV have provided important lessons. Informative vaccine research has been conducted in the mouse infection model of a closely related rodent virus, murine gammaherpesvirus-68 (MHV-68 or γHV-68). This mouse model has generated fundamental principles for an effective vaccination strategy. KSHV vaccines designed to prevent a naïve host from infection and to boost the immune control of KSHV in persistently infected people will have major impact on individuals who are at a high risk of developing KSHV-associated diseases.

SciVerse