Kaposi's sarcoma management from a plastic surgery perspective. 2022

Selman Taskin, and Tugce Yasak, and S Tiber Mentese, and Burak Yilmaz, and Ozlem Çolak
Prof. Dr. Cemil Tascioglu City Hospital, Plastic Reconstructive and Aesthetic Surgery Clinic, Istanbul, Turkey.

Kaposi's sarcoma (KS) is a low-grade angioproliferative tumor arising from endothelial cells and associated with Human Herpes Virus 8 infection. Although there are considerable number of patients referred for surgical excision, the plastic surgery literature on KS is exceptionally scarce. In this study, it was aimed to emphasize the differences in the management of Kaposi's Sarcoma and help to understand the importance of a multidisciplinary approach, accordingly the sake of choosing the ideal treatment method for each lesion. Thirty patients who were operated with the diagnosis of KS between March 2015 and January 2020 were included. Preoperative HIV tests and detailed whole-body examinations of the patients were performed. As a surgical method, for lesions with sizes ranging from 0.5 * 1 cm to 2 * 3 cm, excisions were made over the deep skin fascia by placing a margin between 0.5-1 cm, considering the anatomical location and elasticity of the skin. Primary repair was performed in 23 patients (40 lesions) and 12 lesions of 8 patients were repaired with a skin graft. In four patients the repair was performed with local skin flaps. In a patient with a lesion on the finger, the defect that occurred after the excision of the lesion was repaired with a pedicled regional flap. One-stage surgical excision of the lesions provides remarkable advantages, compared to the therapies such as radiotherapy, laser, or chemotherapy which require several administrations.

UI MeSH Term Description Entries
D006566 Herpesviridae Infections Virus diseases caused by the HERPESVIRIDAE. Herpesvirus Infections,B Virus Infection,Infections, Herpesviridae,Infections, Herpesvirus,B Virus Infections,Herpesviridae Infection,Herpesvirus Infection,Infection, B Virus,Infection, Herpesviridae,Infection, Herpesvirus,Infections, B Virus
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000163 Acquired Immunodeficiency Syndrome An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive T-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. AIDS,Immunodeficiency Syndrome, Acquired,Immunologic Deficiency Syndrome, Acquired,Acquired Immune Deficiency Syndrome,Acquired Immuno-Deficiency Syndrome,Acquired Immuno Deficiency Syndrome,Acquired Immuno-Deficiency Syndromes,Acquired Immunodeficiency Syndromes,Immuno-Deficiency Syndrome, Acquired,Immuno-Deficiency Syndromes, Acquired,Immunodeficiency Syndromes, Acquired,Syndrome, Acquired Immuno-Deficiency,Syndrome, Acquired Immunodeficiency,Syndromes, Acquired Immuno-Deficiency,Syndromes, Acquired Immunodeficiency
D012514 Sarcoma, Kaposi A multicentric, malignant neoplastic vascular proliferation characterized by the development of bluish-red cutaneous nodules, usually on the lower extremities, most often on the toes or feet, and slowly increasing in size and number and spreading to more proximal areas. The tumors have endothelium-lined channels and vascular spaces admixed with variably sized aggregates of spindle-shaped cells, and often remain confined to the skin and subcutaneous tissue, but widespread visceral involvement may occur. Kaposi's sarcoma occurs spontaneously in Jewish and Italian males in Europe and the United States. An aggressive variant in young children is endemic in some areas of Africa. A third form occurs in about 0.04% of kidney transplant patients. There is also a high incidence in AIDS patients. (From Dorland, 27th ed & Holland et al., Cancer Medicine, 3d ed, pp2105-7) HHV-8 is the suspected cause. Kaposi Sarcoma,Kaposi's Sarcoma,Multiple Idiopathic Pigmented Hemangiosarcoma,Kaposis Sarcoma,Sarcoma, Kaposi's
D013518 Surgery, Plastic The branch of surgery concerned with restoration, reconstruction, or improvement of defective, damaged, or missing structures. Cosmetic Surgery,Esthetic Surgery,Plastic Surgery,Surgery, Cosmetic,Surgery, Esthetic,Reconstructive Surgery,Surgery, Reconstructive
D042783 Endothelial Cells Highly specialized EPITHELIAL CELLS that line the HEART; BLOOD VESSELS; and lymph vessels, forming the ENDOTHELIUM. They are polygonal in shape and joined together by TIGHT JUNCTIONS. The tight junctions allow for variable permeability to specific macromolecules that are transported across the endothelial layer. Capillary Endothelial Cells,Lymphatic Endothelial Cells,Vascular Endothelial Cells,Capillary Endothelial Cell,Cell, Capillary Endothelial,Cell, Endothelial,Cell, Lymphatic Endothelial,Cell, Vascular Endothelial,Cells, Capillary Endothelial,Cells, Endothelial,Cells, Lymphatic Endothelial,Cells, Vascular Endothelial,Endothelial Cell,Endothelial Cell, Capillary,Endothelial Cell, Lymphatic,Endothelial Cell, Vascular,Endothelial Cells, Capillary,Endothelial Cells, Lymphatic,Endothelial Cells, Vascular,Lymphatic Endothelial Cell,Vascular Endothelial Cell

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