Correspondence

Kaposi's Sarcoma after Renal Transplantation

N Engl J Med 1997; 336:1761June 12, 1997

Article

To the Editor:

Cancer after transplantation has long been recognized to be a risk associated with immunosuppression, but Kaposi's sarcoma is a rare tumor in this situation.1 A 39-year-old man with end-stage renal disease received an allograft from a living related donor in 1992. He was receiving steroids, azathioprine, and cyclosporine and had stable renal function. Eighteen months after transplantation, a cluster of pigmented lesions appeared in his right calf. Histologic evaluation revealed an infiltrating spindle-cell tumor around eccrine ducts, with hyaline globules and hemosiderin among the slit-like vascular pores — features consistent with Kaposi's sarcoma (Figure 1Figure 1Spindle-Cell Tumor in a Patient after Renal Transplantation and Immunosuppression.).

Repeated testing for the human immunodeficiency virus was negative. Cyclosporine was discontinued, and the lesions regressed completely with no additional therapy. The cyclosporine was reintroduced eight months later because of deteriorating allograft function, with changes observable at biopsy that were consistent with chronic rejection. The Kaposi's sarcoma recurred within four months, leading to the discontinuation of cyclosporine. The Kaposi's sarcoma again regressed completely (Figure 2Figure 2Temporal Relation between the Appearance and Regression of the Kaposi's Sarcoma Lesions and the Introduction and Withdrawal of Cyclosporine.). At this writing, the patient's allograft function is stable with mycophenolate and prednisone therapy.

John P. Vella, M.B.
Rebecca Mosher, M.D.
Mohamed H. Sayegh, M.D.
Brigham and Women's Hospital, Boston, MA 02115

1 References

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   Gotti E, Remuzzi G. Post-transplant Kaposi's sarcoma. J Am Soc Nephrol 1997;8:130-137
   Web of Science | Medline

Citing Articles (7)

Citing Articles

1. 1

   Maria Boratyńska, Sławomir C. Zmonarski, Marian Klinger. (2006) Reccurence of Kaposi's sarcoma after increased exposure to sirolimus. International Immunopharmacology 6:13-14, 2018-2022
   CrossRef

2. 2

   PATRICIA MUÑOZ, PATRICIA ALVAREZ, FERNANDO DE ORY, FRANCISCO POZO, MARISA RIVERA, EMILIO BOUZA. (2002) Incidence and Clinical Characteristics of Kaposi Sarcoma After Solid Organ Transplantation in Spain. Medicine 81:4, 293-304
   CrossRef

3. 3

   J. Paul Zoeteweij, Andrea S. Rinderknecht, David A. Davis, Robert Yarchoan, Andrew Blauvelt. (2002) Minimal reactivation of Kaposi's sarcoma-associated herpesvirus by corticosteroids in latently infected B cell lines. Journal of Medical Virology 66:3, 378-383
   CrossRef

4. 4

   Matthias Behrend. (2001) Mycophenolate Mofetil. BioDrugs 15:1, 37-53
   CrossRef

5. 5

   Szilvia Nagy, Rolland Gyulai, Lajos Kem??ny, P??l Szenohradszky, Attila Dobozy. (2000) IATROGENIC KAPOSI???S SARCOMA HHV8 Positivity Persists But The Tumors Regress Almost Completely Without Immunosuppressive Therapy 1. Transplantation 69:10, 2230-2231
   CrossRef

6. 6

   Oliver K. Eberhard, Volker Kliem, Reinhard Brunkhorst. (1999) FIVE CASES OF KAPOSI'S SARCOMA IN KIDNEY GRAFT RECIPIENTS. Transplantation 67:1, 180-184
   CrossRef

7. 7

   Ruth M. Greenblatt. (1998) KAPOSI'S SARCOMA AND HUMAN HERPESVIRUS-8. Infectious Disease Clinics of North America 12:1, 63-82
   CrossRef