title: Brain localization of Kaposi's sarcoma in a patient treated by combination antiretroviral therapy.
abstract: BACKGROUND
  Central nervous system is a very rare site of Kaposi's sarcoma in acquired immunodeficiency syndrome. Kaposi's sarcoma, a neoplasm of endothelial origin, occurs mainly in the skin, but can involve many tissues, especially in patients with a poor immunity. Combination antiretroviral therapy, highly active against human immunodeficiency virus type-1, has caused a dramatic reduction of cutaneous and visceral involvements. No report of central nervous system localization of Kaposi's sarcoma is described since the introduction of combination antiretroviral therapy in the late 90's.
  
  
  METHODS
  A 42 year-old Caucasian man affected by human immunodeficiency virus type-1 infection treated with combination antiretroviral therapy and showing relatively preserved immunity with low viral load presented gingival squamous cell carcinoma and visceral (lungs and lymph nodes) Kaposi's sarcoma. Chemotherapy and radiotherapy were performed with improvement of both neoplasms. Afterwards, a magnetic resonance imaging showed focal lesions of the brain. Despite new chemotherapy and radiotherapy the patient died. Histology after autopsy revealed brain lesions due to Kaposi's sarcoma with the detection of Human Herpesvirus 8 on tissue samples.
  
  
  CONCLUSIONS
  This is the first report in the combination antiretroviral therapy era of a very rare complication of Kaposi's sarcoma, such as that of brain localization, in a patient with a relatively good control of human immunodeficiency virus infection. Therefore, Kaposi's sarcoma should be considered in differential diagnosis with other intracranial mass lesions that can occur in human immunodeficiency virus infected-patients focusing the issue of appropriate treatment for central nervous system involvement.
authors.affiliation: Clinical Department, National Institute for Infectious Diseases "L, Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy. francesco.baldini@inmi.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Baldini
authors.forename: Andrea
authors.initials: A
authors.lastname: Baiocchini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Schininà
authors.forename: Chiara
authors.initials: C
authors.lastname: Agrati
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Giancola
authors.forename: Lucia
authors.initials: L
authors.lastname: Alba
authors.forename: Susanna
authors.initials: S
authors.lastname: Grisetti
authors.forename: Franca
authors.initials: F
authors.lastname: Del Nonno
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Capobianchi
authors.forename: Andrea
authors.initials: A
authors.lastname: Antinori
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging / Q000821:virology*; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D008297:Male; D011859:Radiography; D012514:Sarcoma, Kaposi / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000821:virology
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents