title: Case report: HIV negative isolated scrotal Kaposi's sarcoma.
abstract: BACKGROUND
  Kaposi's sarcoma (KS) is a rare angioproliferative disorder of the vascular endothelium. The development of KS requires Human Herpes Virus 8 (HHV-8) infection. An associated HIV infection is usually seen. Isolated scrotal KS has rarely been reported. In this article, we present a case of KS that primarily involved the scrotum in a HIV negative patient.
  
  
  METHODS
  A 71-year old male patient admitted to the outpatient department due to nodular lesions on the scrotum. The patient declared that these lesions were present for nearly 5 years. Past medical history revealed that he underwent left thoracotomy and upper lobectomy in 2006 for adenosquamous lung carcinoma. Then, he received a single cycle of adjuvant chemotherapy consisted of docetaxel and cisplatin. Physical examination revealed 3 black small nodules on the scrotum. The anti-HIV test was negative. All scrotal lesions were surgically excised. The pathological investigation revealed KS of the lymphangioma-like type.
  
  
  CONCLUSIONS
  The pathogenesis of KS has still not been clearly elucidated. However, it is known that all forms of KS are associated with HHV-8 infections. A defect in immune system was almost always necessary. Therefore, KS is usually associated with HIV infection. KS of the penis has been reported in HIV negative patients. Very few cases of scrotal KS have been presented. In a recent review, only 1 patient had scrotal KS out of 32 cases with HIV negative KS. In our case, the patient received a cycle of chemotherapy that might affect his immune system. The lymphangioma-like type is a common morphological sub-type. While lymph edemas are commonly observed in this sub-type, no edema in the lymphs was present in our case.
  
  
  CONCLUSIONS
  Classical KS is generally observed in the lower extremities, it can rarely affect scrotal skin as isolated lesions. Therefore, a careful physical examination should also include scrotum for these patients.
authors.affiliation: Department of Urology, Duzce University School of Medicine, Duzce, Turkey. Electronic address: hamidozmen@hotmail.com.
authors.forename: Hamid
authors.initials: H
authors.lastname: Ozmen
authors.affiliation: Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
authors.forename: Dursun
authors.initials: D
authors.lastname: Baba
authors.affiliation: Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
authors.forename: Coskun
authors.initials: C
authors.lastname: Kacagan
authors.affiliation: Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Kayikci
authors.affiliation: Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Cam
keywords: Case report; Kaposi's sarcoma; Scrotum