title: Endoscopic Appearance of Oropharyngeal and Upper GI Kaposi's Sarcoma in an Immunocompromised Patient.
abstract: Introduction. Kaposi's sarcoma (KS) usually manifests as a cutaneous disease but GI manifestation is often rare. It is associated with human herpes virus-8 (HHV-8) and seen in immunocompromised patients. In the USA, use of highly active antiretroviral therapy (HAART) has drastically reduced incidence of KS in HIV patients.Case Presentation. A 65-year-old male with human immunodeficiency virus (HIV) was admitted to the intensive care unit (ICU) with cardiopulmonary arrest secondary to hyperkalemia of 7.5 meq/L. Following placement of orogastric and endotracheal tube (ETT), a significant amount of blood was noticed in the ETT. Hemoglobin trended down from 9.6 mg/dL to 6.7 mg/dL over five days. Stool guaiac was positive. Esophagogastroduodenoscopy (EGD) was performed and revealed multiple large hypervascularized violaceous submucosal nodular lesions with stigmata of bleeding seen on the soft palate and pharynx and within the cricopharyngeal area close to the vocal cords. Biopsy of the soft palate lesions showed proliferation of neoplastic spindle shaped cells arranged in bundles with slit-like capillary spaces containing erythrocytes consistent with Kaposi's sarcoma. Biopsy was positive for HHV-8. Colonoscopy was unremarkable. There were no cutaneous manifestations of the disease.Conclusion. GI involvement of Kaposi's sarcoma must be considered in immunocompromised patients and can be confirmed by endoscopic methods.
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Umar
authors.identifier: 0000-0002-1487-2286
authors.initials: U
authors.lastname: Darr
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Anas
authors.initials: A
authors.lastname: Renno
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Zubair
authors.initials: Z
authors.lastname: Khan
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Turki
authors.initials: T
authors.lastname: Alkully
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Maitham A
authors.identifier: 0000-0002-5755-9388
authors.initials: MA
authors.lastname: Moslim
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Sehrish
authors.initials: S
authors.lastname: Kamal
authors.affiliation: University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Nawras