A case of exogenous corticosteroid-induced Kaposi's sarcoma that developed after a cure of endogenous hypercortisolism.
Case Kaposi's sarcoma (KS) is a malignant vascular tumor that occurs commonly in patients with acquired immunodeficiency syndrome. KS associated with Cushing's syndrome (CS) is unusual, especially in endogenous CS. Here, we report a case of KS associated with glucocorticoid-replacement therapy after surgical treatment for adrenal CS. A 70-year-old man presented with symptoms and signs of CS with a left adrenal mass. Adrenal CS was confirmed by biochemical studies. After left adrenalectomy, he took oral prednisolone (15 mg/day) to prevent adrenal insufficiency. Ten weeks later, numerous raised purple plaques on the lower extremities were newly detected. The biopsy findings were compatible with KS, but anti-HIV antibodies were negative. After withdrawal of glucocorticoid therapy, the skin lesions regressed completely.


CONCLUSIONS
In this case, KS developed after the use of exogenous corticosteroid but not during endogenous hypercortisolism. This finding suggests that endogenous and exogenous corticosteroid play different roles in the development of KS.
Department of Internal Medicine, Jeju National University Hospital, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea.
Soyeon
S
Yoo
Department of Internal Medicine, Jeju National University Hospital, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea.
Shinhang
S
Moon
Department of Internal Medicine, Jeju National University Hospital, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea.
Sang-Ouk
SO
Chin
Department of Internal Medicine, Jeju National University Hospital, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea.|Department of Internal Medicine, Jeju National University School of Medicine, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea.
Sang-Ah
SA
Lee
Department of Pathology, Jeju National University School of Medicine, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea.
Changlim
C
Hyun
Department of Internal Medicine, Jeju National University Hospital, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea. okdom@jejunu.ac.kr.|Department of Internal Medicine, Jeju National University School of Medicine, 15, Aran 13-gil, Jeju-Si, Jeju-do, 690-767, Korea. okdom@jejunu.ac.kr.
Gwanpyo
G
Koh
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use*; D000315:Adrenalectomy; D000368:Aged; D003480:Cushing Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000139:chemically induced* / Q000473:pathology; D012867:Skin / Q000473:pathology
D000305:Adrenal Cortex Hormones; D011239:Prednisolone
Corticosteroid; Cushing’s syndrome; Glucocorticoid; Kaposi’s sarcoma