Ann Dermatol.  2011 Nov;23(4):504-507.

Treatment of Disseminated Classic Type of Kaposi's Sarcoma with Paclitaxel

• Kim SY
• Kim DH
• Lee HJ
• Seo YJ
• Lee JH
• Lee Y

Abstract

Classic Kaposi sarcoma (KS) is a rare human herpes virus 8-associated angioproliferative disease, and the disseminated classic type of KS in Korea is even rarer. The treatment options for classic KS vary and range from surgical excision to ionizing irradiation or chemotherapy. Recently, there have been a few reports of treating classic KS with paclitaxel, which has been used to treat AIDS-associated KS and post-transplant KS. We herein report a case of disseminated classic type KS in a 78-year-old Korean male patient who showed dramatic response after only two cycles of paclitaxel treatment.

Keyword

Kaposi sarcoma; Paclitaxel

MeSH Terms

Humans
Korea
Male
Paclitaxel
Sarcoma, Kaposi
Viruses
Paclitaxel

Figure

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  Fig. 1 (A) Clinical appearance before treatment with paclitaxel. Multiple reddish-purple plaques and patches with pitting edema distributed widely on upper and lower extremities. (B) Residual hyperpigmented patches after 2 infusions of paclitaxel. Note the edema has all resolved and nearly skin lesions are disappeared.

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  Fig. 2 (A) Skin biopsy specimen showing infiltrate of spindles shaped cells and slit-like vascular spaces containing erythrocytes in Kaposi's sarcoma (H&E stain, ×200). (B) CD31 stain showing positive reaction to well-formed flattened endothelial cell lining the vascular cleft and spindle-shaped stromal cells (×200). (C) CD34 stain showing prominent positive reaction in the spindle cell population (×200).

Reference

1. Sarid R, Klepfish A, Schattner A. Virology, pathogenetic mechanisms, and associated diseases of Kaposi sarcoma-associated herpesvirus (human herpesvirus 8). Mayo Clin Proc. 2002. 77:941–949.

2. Ensoli B, Stürzl M. Kaposi's sarcoma: a result of the interplay among inflammatory cytokines, angiogenic factors and viral agents. Cytokine Growth Factor Rev. 1998. 9:63–83.

3. Kang MJ, Kim TY. Recurrent classical type of Kaposi's sarcoma treated by interferon-alpha. Ann Dermatol. 2008. 20:162–165.

4. Sung JC, Louie SG, Park SY. Kaposi's sarcoma: advances in tumor biology and pharmacotherapy. Pharmacotherapy. 1997. 17:670–683.

5. Fenig E, Brenner B, Rakowsky E, Lapidoth M, Katz A, Sulkes A. Classic Kaposi sarcoma: experience at Rabin Medical Center in Israel. Am J Clin Oncol. 1998. 21:498–500.

6. Rowinsky EK. Paclitaxel pharmacology and other tumor types. Semin Oncol. 1997. 24:6 Suppl 19. S19-1–S19-12.

7. Schwartz RA. Kaposi's sarcoma: an update. J Surg Oncol. 2004. 87:146–151.

8. Kim HO, Lee BY, Han HJ, Park CW, Lee CH, Kim JH. A case of Kaposi's sarcoma treated with paclitaxel. Korean J Dermatol. 2005. 43:1119–1123.

9. Iscovich J, Boffetta P, Winkelmann R, Brennan P, Azizi E. Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study. AIDS. 1998. 12:2067–2072.

10. Cattani P, Cerimele F, Porta D, Graffeo R, Ranno S, Marchetti S, et al. Age-specific seroprevalence of Human Herpesvirus 8 in Mediterranean regions. Clin Microbiol Infect. 2003. 9:274–279.

11. Levi MJ. Classic Kaposi's sarcoma. J Am Podiatr Med Assoc. 2005. 95:586–588.

12. Tschachler E. Wolff K, Goldsmith LA, Kats SI, Girchrest BA, Paller AS, Leffel D, editors. Kaposi sarcoma. Fitzpatrick's dermatology in general medicine. 2008. 7th ed. New York: McGrow-Hill;1183–1187.

13. Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: a continuing conundrum. J Am Acad Dermatol. 2008. 59:179–206.

14. Toschi E, Sgadari C, Monini P, Barillari G, Bacigalupo I, Palladino C, et al. Treatment of Kaposi's sarcoma--an update. Anticancer Drugs. 2002. 13:977–987.

15. Brambilla L, Romanelli A, Bellinvia M, Ferrucci S, Vinci M, Boneschi V, et al. Weekly paclitaxel for advanced aggressive classic Kaposi sarcoma: experience in 17 cases. Br J Dermatol. 2008. 158:1339–1344.

16. Baskan EB, Tunali S, Adim SB, Kiyici M, Ali R. Treatment of advanced classic Kaposi's sarcoma with weekly low-dose paclitaxel therapy. Int J Dermatol. 2006. 45:1441–1443.

17. Sgadari C, Toschi E, Palladino C, Barillari G, Carlei D, Cereseto A, et al. Mechanism of paclitaxel activity in Kaposi's sarcoma. J Immunol. 2000. 165:509–517.

18. Fardet L, Stoebner PE, Bachelez H, Descamps V, Kerob D, Meunier L, et al. Treatment with taxanes of refractory or life-threatening Kaposi sarcoma not associated with human immunodeficiency virus infection. Cancer. 2006. 106:1785–1789.