title: Kaposi Sarcoma in the Genital Area in a Kidney Transplant Patient: A Case Report and Literature Review.
abstract: BACKGROUND
  Kaposi sarcoma (KS) is a cancer with an incidence in patients after transplantation (Tx) that is 500 times greater than that in the healthy population. The risk of KS increases significantly during therapy, especially when immunosuppressive therapy with cyclosporine A (CsA) is used. Most cases of KS develop during the first 2 years after transplantation. After a KS diagnosis, it is recommended to reduce the doses of immunosuppressive medications. Conversion of immunosuppressive treatment into mammalian target of rapamycin (m-TOR) inhibitors is strongly suggested.
  
  
  METHODS
  We present the case of a 65-year-old man with end-stage renal disease (ESRD) of unknown etiology, who had kidney transplantation in 2008. Immunosuppressive protocol was based on CsA, mycophenolate mofetil (MMF) and prednisolone (PRE). In 2011, during the dermatological consultation, on the penis glans a purple stain of uneven surface was noted. Histology study revealed the presence of KS. The treatment was modified. The patient was converted from CsA to everolimus. Before converting, the creatinine concentration was 1.79 mg/dl and proteinuria less than 0.3 g/day.
  
  
  RESULTS
  The change in the scheme of immunosuppresion from CsA to everolimus was performed to treat the Kaposi sarcoma. Gradually, within a year, the KS was cured. However, the graft function deteriorated, and the graft was lost in one-years' time.
  
  
  CONCLUSIONS
  We present the first documented case of KS in the genital area of a kidney patient. The reduction in the strength of immunosuppression, and the introduction of an m-TOR inhibitor, may have contributed to the deterioration of kidney function, however it was substantial in the treatment of KS.
authors: Copernicus-Independent Public Healthcare Centre, Dermatology & Venereology Clinic, Gdansk, Poland; College of Health, Beauty and Education in Poznan, Poland. Electronic address: bimko@wp.pl.
authors: B
authors: B
authors: Imko-Walczuk
authors: College of Health, Beauty and Education in Poznan, Poland.
authors: M
authors: M
authors: Kielbowicz
authors: 1st Department of Nephrology and Transplantology with Dialysis Unit, Medical University, Bialystok, Poland.
authors: J
authors: J
authors: Malyszko
authors: 2nd Department of Nephrology Medical University, Bialystok, Poland.
authors: J
authors: J
authors: Malyszko
authors: 1st Department of Nephrology and Transplantology with Dialysis Unit, Medical University, Bialystok, Poland.
authors: M
authors: M
authors: Barczyk
authors: Chair & Clinic of Nephrology, Transplantology and Internal Medicine, Gdansk University of Medical Sciences, Gdansk, Poland.
authors: A
authors: A
authors: Debska-Slizien
authors: 1st Department of Nephrology and Transplantology with Dialysis Unit, Medical University, Bialystok, Poland.
authors: M
authors: M
authors: Mysliwiec
authors: Chair & Clinic of Nephrology, Transplantology and Internal Medicine, Gdansk University of Medical Sciences, Gdansk, Poland.
authors: B
authors: B
authors: Rutkowski
mesh_terms: D000368:Aged; D016572:Cyclosporine / Q000009:adverse effects; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects; D010412:Penile Neoplasms / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000276:immunology*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D011239:Prednisolone; D009173:Mycophenolic Acid