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HIV

Ocular Kaposi Sarcoma Associated With Systemic Disease and Complete Resolution After Medical Therapy

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A man in his mid-50s with previously untreated HIV 1 infection presented with bilateral, violaceous, caruncular lesions. Examination of the left eye showed a violaceous, firm, pedunculated mass protruding nearly 10 mm, extending into the adjacent conjunctiva, and additional eyelid lesions with mild edema (Figure, A). Pathologic examination of similar-appearing oral mucosa lesions showed vascular and spindle cell proliferation with fascicles of atypical spindle cells that stained strongly for human herpesvirus 8, CD31, and erythroblast transformation specific–related gene, confirming a diagnosis of Kaposi sarcoma.1 Further evaluation revealed a CD4 helper T-cell count of 13 cells/μL and bilateral lung and possible liver involvement. The patient started highly active antiretroviral therapy (HAART) and liposomal doxorubicin treatment given the presence of concurrent systemic disease. Nearly 8 months later, examination showed complete regression of bilateral ocular lesions (Figure, B). Ocular Kaposi sarcoma is rarely described as an AIDS-defining illness.2,3 Importantly, active eye disease may be associated with systemic disease.

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Article Information

Corresponding Author: Amy M. Huang, MD, Department of Ophthalmology, University of Colorado Hospital, 1675 Aurora Ct, MS F731, Aurora, CO 80045 (amy.m.huang@cuanschutz.edu).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information and Loes Nardi-Korver, MD, University of Colorado, for her help with the pathology image. No one was financially compensated for their contribution.

References
1.
Grayson  W , Pantanowitz  L .  Histological variants of cutaneous Kaposi sarcoma.   Diagn Pathol. 2008;3(1):31. doi:10.1186/1746-1596-3-31PubMedGoogle ScholarCrossref
2.
Donovan  C , Patel  H , Shetty  S , Bierman  L , Lustbader  JM , Oboh-Weilke  AM .  Aggressive conjunctival Kaposi sarcoma as the initial manifestation of acquired immunodeficiency syndrome.   Am J Ophthalmol Case Rep. 2020;19:100832. doi:10.1016/j.ajoc.2020.100832PubMedGoogle ScholarCrossref
3.
Jin  C , Minhas  H , Kaur  A , Kodali  S , Gotlieb  V .  A case of ocular Kaposi’s sarcoma successfully treated with highly active antiretroviral therapy (HAART) combined with docetaxel.   Am J Case Rep. 2018;19:1074-1077. doi:10.12659/AJCR.910374PubMedGoogle ScholarCrossref
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