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Story MT, Sanders ML, Bashir AA, Longo JM, Abel SL, Dollard SC, Grodstein EI, Thomas CP, Katz DA. Infiltrating Kaposi sarcoma presenting as acute kidney injury: An unexpected consequence of deliberate hepatitis C-positive organ transplantation. Transpl Infect Dis 2021; 23:e13481. [PMID: 33012057 DOI: 10.1111/tid.13481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/06/2020] [Accepted: 09/20/2020] [Indexed: 11/30/2022]
Abstract
Kaposi sarcoma (KS) following kidney transplantation can result from recipient reactivation of latent human herpesvirus 8 (HHV-8) infection or activation of donor-acquired HHV-8 infection. Post-transplant KS typically manifests with cutaneous pathology, but rare cases of renal allograft involvement have been reported. We describe two cases of donor-derived HHV-8 infection in two hepatitis C (HCV) viremia-negative transplant recipients who each received a kidney from a donor with HCV viremia. One recipient did not develop KS while the other presented with acute kidney injury caused by extensive KS infiltration of the renal parenchyma and metastatic disease. This report reviews the literature for cases of KS involving the renal allograft and highlights an unexpected consequence of deliberate HCV-positive organ transplantation.
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Affiliation(s)
- Maria T Story
- Department Medicine, Division of Nephrology, University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
| | - M Lee Sanders
- Department Medicine, Division of Nephrology, University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
- Iowa City VA Health Care System, Iowa City, IA, USA
| | - Amani A Bashir
- Department of Pathology, University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
| | - Jude M Longo
- Iowa City VA Health Care System, Iowa City, IA, USA
- Department of Radiology, University of Iowa Roy and Lucille Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Stacy L Abel
- Iowa City VA Health Care System, Iowa City, IA, USA
| | | | - Elliot I Grodstein
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Christie P Thomas
- Department Medicine, Division of Nephrology, University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
- Iowa City VA Health Care System, Iowa City, IA, USA
| | - Daniel A Katz
- Iowa City VA Health Care System, Iowa City, IA, USA
- Department of Surgery, University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
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Gasparis AP, Kokkosis A, Labropoulos N, Tassiopoulos AK, Ricotta JJ. Venous Outflow Obstruction With Retroperitoneal Kaposi's Sarcoma and Treatment With Inferior Vena Cava Stenting. Vasc Endovascular Surg 2009; 43:295-300. [DOI: 10.1177/1538574408328666] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 26-year-old man presented with acute renal insufficiency, and severe lower extremity swelling. Computed tomographic scan revealed retroperitoneal lymphadenopathy encasing both ureters and the inferior vena cava. He underwent placement of ureteral stents to relieve the obstruction and afterward underwent lymph node biopsy, which revealed Kaposi's sarcoma. He subsequently was diagnosed with acquired immunodeficiency syndrome. Abdominal and lower extremity venous duplex ultrasound did not show any evidence of deep vein thrombosis. The inferior vena cava measured 3.5 mm in diameter and was encased by retroperitoneal lymphadenopathy. Bilateral transfemoral venography and intravascular ultrasound demonstrated significant compression of the inferior vena cava below the renal veins. Endovascular treatment was followed with primary stenting under intravascular ultrasound guidance. His symptoms improved with reduction in swelling. At 1-year follow-up, the patient was ambulatory with mild symptoms, and on venography the iliac vein and inferior vena cava stents were widely patent.
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Affiliation(s)
| | - Angela Kokkosis
- Stony Brook University Medical Center, Stony Brook, New York
| | | | | | - John J. Ricotta
- Stony Brook University Medical Center, Stony Brook, New York
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Pantanowitz L, Dezube BJ. Kaposi sarcoma in unusual locations. BMC Cancer 2008; 8:190. [PMID: 18605999 PMCID: PMC2464778 DOI: 10.1186/1471-2407-8-190] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Accepted: 07/07/2008] [Indexed: 11/10/2022] Open
Abstract
Kaposi sarcoma (KS) is a multifocal, vascular lesion of low-grade malignant potential that presents most frequently in mucocutaneous sites. KS also commonly involves lymph nodes and visceral organs. This article deals with the manifestation of KS in unusual anatomic regions. Unusual locations of KS involvement include the musculoskeletal system, central and peripheral nervous system, larynx, eye, major salivary glands, endocrine organs, heart, thoracic duct, urinary system and breast. The development of KS within wounds and blood clots is also presented. KS in these atypical sites may prove difficult to diagnose, resulting in patient mismanagement. Theories to explain the rarity and development of KS in these unusual sites are discussed.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
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De Blasio A, Palmiero G, Russo D. Kaposi's sarcoma occurring in a young black man after kidney transplantation. Nephrol Dial Transplant 2005; 20:2839-41. [PMID: 16221707 DOI: 10.1093/ndt/gfi182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Antonietta De Blasio
- Department of Nephrology, School of Medicine, University Frederico, Naples, Italy
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