BI12: A retrospective analysis of cases of Kaposi sarcoma in patients at a tertiary centre

Dalvir Bajwa, Pooja Jassal-Prior and Dominic Tabor

Department of Dermatology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK

Kaposi sarcoma (KS) is a neoplasm of endothelial cell origin, associated with human herpesvirus 8 (HHV8). The lesions typically occur in elderly Eastern European and Mediterranean men, and may present as four distinct clinical subtypes: classic, endemic, iatrogenic, and epidemic or HIV-related. This retrospective, single-centre study examined the clinical presentation and disease progression of patients with KS. Patients with a histologically confirmed KS, diagnosed at a single, large, tertiary centre in England between 2011 and 2021, were identified via SNOMED codes. Clinical information was collected via electronic notes, patient letters and histology reports. Twenty-four patients were diagnosed histologically with KS. Median age at diagnosis was 51 years (interquartile range 43–72). Eighteen patients were white; the other patients were of Mediterranean (n = 2), African (n = 2), and Asian (n = 1) origin (with one not providing information). Eighty-three per cent of patients were male (n = 20) and 17% were female (n = 4). Ten patients had the classic KS subtype, eight had epidemic or HIV-associated KS, five had iatrogenic KS and one had endemic (African) KS. Patients with iatrogenic KS had immunosuppression from a range of causes, including transplant (n = 2), immunosuppressant medications and diseases such as lymphoma. All 24 patients presented with typical erythematous or violaceous macules or papules. Thirteen patients had single lesions, six had between one and five lesions, and five patients had > 5 lesions. The majority of lesions occurred on the lower limbs (n = 15). One patient had disseminated KS at the time of presentation, diagnosed concurrently with HIV. Treatment modalities included excision (n = 14), including amputation in one patient; radiotherapy (n = 1); and chemotherapy (n = 2). Four patients were treated solely with antiretroviral therapy for HIV, and one patient was awaiting treatment following the completion of chemotherapy for lymphoma. One patient developed recurrent, disseminated disease. The two patients with disseminated disease both died. There are an estimated 1642 new cases of KS across the EU27 per year (Stiller C, Trama A, Brewster D et al. Descriptive epidemiology of Kaposi sarcoma in Europe. Report from the RARECARE project. Cancer Epidemiol 2014; 38: 670–8). Although KS remains an AIDS-defining illness, the advent of combination antiretroviral therapy in 1995 has dramatically reduced the risk of KS among HIV-positive patients. In this study, two-thirds of new diagnoses occurred in HIV-negative patients. Awareness of this evolving epidemiology among dermatologists is important to facilitate early diagnosis and appropriate treatment.

BI13

Abstract withdrawn.