By Dr Ananya Mandal, MD
Kaposi's sarcoma is a cancer that affects the linings of the blood vessels of lymphatic channels in persons with a lowered immunity typically patients with HIV infection.
Types of Kaposi's sarcoma
Classic Kaposi's sarcoma is rare and affects elderly men of Mediterranean or Ashkenazi Jewish origin.
Endemic or African Kaposi's sarcoma affects young adults living in equatorial Africa. These patients usually have a normal immune system.
Course of the disease
In most cases the course of the disease is slow but in some patients it may assume an aggressive and faster progress.
Children can also be affected with the endemic variety. This form in children usually affects the lymphatic channels and may spread to other organs and become life threatening.
Symptoms of Kaposi's sarcoma
Symptoms of Kaposi's sarcoma include (1-4):
- Node like raised or blotchy flat patches over the skin. These are red, purple, brown or black. These are usually the first symptoms of Kaposi's sarcoma. The lesions can develop quickly and enlarge in size.
Although there may be a single area at first, it is possible for more than one to appear. Often the lesions merge to form a larger tumor. They are most commonly seen over the face around the mouth, ears and tip of the nose. Lesions are also seen commonly over the legs and feet, and genital area.
In dark skinned individuals the lesions are noted as dark brown or black.
- Lesions similar to those on the skin are sometimes visible under or on mucous membranes especially in the mouth, nose, gums, tongue, over the tonsils, over the palate (roof of the mouth) or throat.
- The skin lesions are more often than not painless and non-itchy. They may become painful if there is inflammation or swelling.
- There may be a superimposed or secondary bacterial infection over the skin lesions. Since the patient usually has lowered immunity there is also a risk of secondary infections in other organs like lungs (e.g. pneumonia) etc.
- Some aggressive tumors may spread to other organs. If the spread is in lungs there are respiratory problems and associated symptoms. In case of liver metastasis there are signs of liver damage like jaundice etc.
- Lesions occurring in the oesophagus (food pipe) or respiratory tract may grow to obstruct feeding or breathing respectively.
- Lung affection may lead to breathing difficulties, blood in the sputum and respiratory failure, gastrointestinal tract affection may lead to bleeding (that may be fatal) and affliction of the lymphatic channels may lead to swollen lymph nodes and lymphatic channels.
Swollen and blocked lymphatic channels lead to swollen limbs and is called lymphedema. Lesions in the gastrointestinal tract may lead to nausea, diarrhea, bleeding with stools and vomiting in some individuals.
- Over a long term bleeding may lead to anemia. This is caused due to lowering in the number of red blood cells.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)