Oral Kaposi sarcoma in Brazil: a case series of 40 patients highlighting a significant health burden

Lucas Lacerda de Souza; Ivan José Correia-Neto; Yuri Kalinin; Flávia Sirotheau Corrêa Pontes; Alan Roger Santos-Silva; Pablo Agustin Vargas; Marcio Ajudarte Lopes; Hélder Antônio Rebelo Pontes

doi:10.1016/j.oooo.2024.12.014

Oral Kaposi sarcoma in Brazil: a case series of 40 patients highlighting a significant health burden

Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Dec 19:S2212-4403(24)00948-9. doi: 10.1016/j.oooo.2024.12.014. Online ahead of print.

Authors

Lucas Lacerda de Souza¹, Ivan José Correia-Neto¹, Yuri Kalinin², Flávia Sirotheau Corrêa Pontes³, Alan Roger Santos-Silva¹, Pablo Agustin Vargas¹, Marcio Ajudarte Lopes¹, Hélder Antônio Rebelo Pontes⁴

Affiliations

¹ Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
² City Hall of the Seaside Resort of Praia Grande, São Paulo, Brazil.
³ Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Pará, Brazil.
⁴ Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Pará, Brazil. Electronic address: [email protected].

PMID: 39779389
DOI: 10.1016/j.oooo.2024.12.014

Abstract

Objective: The aim of this study was to provide a comprehensive clinicopathological analysis of oral Kaposi sarcoma (KS) cases and examine its relationship with HIV-related immunosuppression.

Study design: Paraffin-embedded tissue blocks of patients microscopically diagnosed with oral KS were retrieved from three oral and maxillofacial pathology files. Data including clinical, laboratory, microscopic and immunohistochemical findings and treatment employed were retrieved.

Results: A total of 40 patients with an average age of 33.5 years, with a male predominance were retrieved. The most common site was the hard palate, followed by the gingiva. Oral lesions were the first sign of KS in 57.5% of cases. Laboratory findings revealed an average viral load of 185,416 copies/mL, a mean CD4 count of 159.95 cells/mm³, CD8 count of 1062.65 cells/mm³, and a CD4/CD8 ratio of 0.148 cells/mm³. Histopathology showed spindle-shaped cell proliferation, vascular channels, hemorrhage, and hemosiderin deposits. Immunohistochemistry confirmed positivity for CD34, CD31, and HHV-8. Patients were treated with highly active antiretroviral therapy (HAART) (75%), and chemotherapy (47.5%).

Conclusion: Oral KS remains a significant marker of HIV-related immunosuppression, especially where the burden of disease remains substantial. While HAART plays a critical role in managing KS, combined chemotherapy is often necessary for advanced cases.