Primary Classic Kaposi's Sarcoma of the Penis in an HIV-Negative Patient
Identifieur interne : 002339 ( Pmc/Corpus ); précédent : 002338; suivant : 002340Primary Classic Kaposi's Sarcoma of the Penis in an HIV-Negative Patient
Auteurs : Kwang Ho Kim ; Joon Il Choi ; Kyoung Ho Ryu ; In Ho Kang ; Yi Hsueh Leng ; Jun Woo Lee ; Jong Woo Lee ; Yoon Jung Kim ; Jeong Ki LeeSource :
- Korean Journal of Urology [ 2005-6737 ] ; 2010.
Abstract
Kaposi's sarcoma (KS) is a multifocal hemorrhagic sarcoma that occurs primarily on the extremities. KS limited to the penis is rare and a well-recognized manifestation of acquired immune deficiency syndrome (AIDS). However, KS confined to the penis is extraordinary in human immunodeficiency virus (HIV)-negative patients. We present the case of a 68-year-old man with a dark reddish ulcerated nodule on the penile skin, which was reported as a nodular stage of KS. We detected no evidence of immunosuppression or AIDS or systemic involvements in further evaluations. In his past medical history, the patient had undergone three transurethral resections of bladder tumors due to urothelial cell carcinoma since 2000 and total gastrectomy, splenectomy, and adjuvant fluorouracil/cisplatin chemotherapy for 7 months due to advanced gastric carcinoma in 2005. The patient was circumcised and has had no recurrence for 2 years.
Url:
DOI: 10.4111/kju.2010.51.11.803
PubMed: 21165204
PubMed Central: 2991581
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Primary Classic Kaposi's Sarcoma of the Penis in an HIV-Negative Patient</title><author><name sortKey="Kim, Kwang Ho" sort="Kim, Kwang Ho" uniqKey="Kim K" first="Kwang Ho" last="Kim">Kwang Ho Kim</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Choi, Joon Il" sort="Choi, Joon Il" uniqKey="Choi J" first="Joon Il" last="Choi">Joon Il Choi</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Ryu, Kyoung Ho" sort="Ryu, Kyoung Ho" uniqKey="Ryu K" first="Kyoung Ho" last="Ryu">Kyoung Ho Ryu</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Kang, In Ho" sort="Kang, In Ho" uniqKey="Kang I" first="In Ho" last="Kang">In Ho Kang</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Leng, Yi Hsueh" sort="Leng, Yi Hsueh" uniqKey="Leng Y" first="Yi Hsueh" last="Leng">Yi Hsueh Leng</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Lee, Jun Woo" sort="Lee, Jun Woo" uniqKey="Lee J" first="Jun Woo" last="Lee">Jun Woo Lee</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Lee, Jong Woo" sort="Lee, Jong Woo" uniqKey="Lee J" first="Jong Woo" last="Lee">Jong Woo Lee</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Kim, Yoon Jung" sort="Kim, Yoon Jung" uniqKey="Kim Y" first="Yoon Jung" last="Kim">Yoon Jung Kim</name><affiliation><nlm:aff id="A2">Department of Pathology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Lee, Jeong Ki" sort="Lee, Jeong Ki" uniqKey="Lee J" first="Jeong Ki" last="Lee">Jeong Ki Lee</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21165204</idno><idno type="pmc">2991581</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991581</idno><idno type="RBID">PMC:2991581</idno><idno type="doi">10.4111/kju.2010.51.11.803</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">002339</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002339</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Primary Classic Kaposi's Sarcoma of the Penis in an HIV-Negative Patient</title><author><name sortKey="Kim, Kwang Ho" sort="Kim, Kwang Ho" uniqKey="Kim K" first="Kwang Ho" last="Kim">Kwang Ho Kim</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Choi, Joon Il" sort="Choi, Joon Il" uniqKey="Choi J" first="Joon Il" last="Choi">Joon Il Choi</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Ryu, Kyoung Ho" sort="Ryu, Kyoung Ho" uniqKey="Ryu K" first="Kyoung Ho" last="Ryu">Kyoung Ho Ryu</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Kang, In Ho" sort="Kang, In Ho" uniqKey="Kang I" first="In Ho" last="Kang">In Ho Kang</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Leng, Yi Hsueh" sort="Leng, Yi Hsueh" uniqKey="Leng Y" first="Yi Hsueh" last="Leng">Yi Hsueh Leng</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Lee, Jun Woo" sort="Lee, Jun Woo" uniqKey="Lee J" first="Jun Woo" last="Lee">Jun Woo Lee</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Lee, Jong Woo" sort="Lee, Jong Woo" uniqKey="Lee J" first="Jong Woo" last="Lee">Jong Woo Lee</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Kim, Yoon Jung" sort="Kim, Yoon Jung" uniqKey="Kim Y" first="Yoon Jung" last="Kim">Yoon Jung Kim</name><affiliation><nlm:aff id="A2">Department of Pathology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Lee, Jeong Ki" sort="Lee, Jeong Ki" uniqKey="Lee J" first="Jeong Ki" last="Lee">Jeong Ki Lee</name><affiliation><nlm:aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</nlm:aff></affiliation></author></analytic><series><title level="j">Korean Journal of Urology</title><idno type="ISSN">2005-6737</idno><idno type="eISSN">2005-6745</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Kaposi's sarcoma (KS) is a multifocal hemorrhagic sarcoma that occurs primarily on the extremities. KS limited to the penis is rare and a well-recognized manifestation of acquired immune deficiency syndrome (AIDS). However, KS confined to the penis is extraordinary in human immunodeficiency virus (HIV)-negative patients. We present the case of a 68-year-old man with a dark reddish ulcerated nodule on the penile skin, which was reported as a nodular stage of KS. We detected no evidence of immunosuppression or AIDS or systemic involvements in further evaluations. In his past medical history, the patient had undergone three transurethral resections of bladder tumors due to urothelial cell carcinoma since 2000 and total gastrectomy, splenectomy, and adjuvant fluorouracil/cisplatin chemotherapy for 7 months due to advanced gastric carcinoma in 2005. The patient was circumcised and has had no recurrence for 2 years.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gonen, M" uniqKey="Gonen M">M Gönen</name></author><author><name sortKey="Cenker, A" uniqKey="Cenker A">A Cenker</name></author><author><name sortKey="Kiyici, H" uniqKey="Kiyici H">H Kiyici</name></author><author><name sortKey="Kalkan, M" uniqKey="Kalkan M">M Kalkan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Micali, G" uniqKey="Micali G">G Micali</name></author><author><name sortKey="Nasca, Mr" uniqKey="Nasca M">MR Nasca</name></author><author><name sortKey="De Pasquale, R" uniqKey="De Pasquale R">R De Pasquale</name></author><author><name sortKey="Innocenzi, D" uniqKey="Innocenzi D">D Innocenzi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pettaway, Ca" uniqKey="Pettaway C">CA Pettaway</name></author><author><name sortKey="Lynch, Df" uniqKey="Lynch D">DF Lynch</name></author><author><name sortKey="Davis, Jw" uniqKey="Davis J">JW Davis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pacifico, A" uniqKey="Pacifico A">A Pacifico</name></author><author><name sortKey="Piccolo, D" uniqKey="Piccolo D">D Piccolo</name></author><author><name sortKey="Fargnoli, Mc" uniqKey="Fargnoli M">MC Fargnoli</name></author><author><name sortKey="Peris, K" uniqKey="Peris K">K Peris</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schwartz, Ra" uniqKey="Schwartz R">RA Schwartz</name></author><author><name sortKey="Cohen, Jb" uniqKey="Cohen J">JB Cohen</name></author><author><name sortKey="Watson, Ra" uniqKey="Watson R">RA Watson</name></author><author><name sortKey="Gasc N, P" uniqKey="Gasc N P">P Gascón</name></author><author><name sortKey="Ahkami, Rn" uniqKey="Ahkami R">RN Ahkami</name></author><author><name sortKey="Ruszczak, Z" uniqKey="Ruszczak Z">Z Ruszczak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lucia, Ms" uniqKey="Lucia M">MS Lucia</name></author><author><name sortKey="Miller, Gj" uniqKey="Miller G">GJ Miller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zargari, O" uniqKey="Zargari O">O Zargari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chitale, Sv" uniqKey="Chitale S">SV Chitale</name></author><author><name sortKey="Peat, D" uniqKey="Peat D">D Peat</name></author><author><name sortKey="Meaden, Jd" uniqKey="Meaden J">JD Meaden</name></author><author><name sortKey="Johnson, Hb" uniqKey="Johnson H">HB Johnson</name></author><author><name sortKey="Burgess, Na" uniqKey="Burgess N">NA Burgess</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morelli, L" uniqKey="Morelli L">L Morelli</name></author><author><name sortKey="Pusiol, T" uniqKey="Pusiol T">T Pusiol</name></author><author><name sortKey="Piscioli, F" uniqKey="Piscioli F">F Piscioli</name></author><author><name sortKey="Hofler, H" uniqKey="Hofler H">H Höfler</name></author><author><name sortKey="Weirich, G" uniqKey="Weirich G">G Weirich</name></author><author><name sortKey="Werner, M" uniqKey="Werner M">M Werner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Kb" uniqKey="Lee K">KB Lee</name></author><author><name sortKey="Lee, Hs" uniqKey="Lee H">HS Lee</name></author><author><name sortKey="Lee, He" uniqKey="Lee H">HE Lee</name></author><author><name sortKey="Park, Sy" uniqKey="Park S">SY Park</name></author><author><name sortKey="Chung, Jh" uniqKey="Chung J">JH Chung</name></author><author><name sortKey="Choe, G" uniqKey="Choe G">G Choe</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Korean J Urol</journal-id><journal-id journal-id-type="publisher-id">KJU</journal-id><journal-title-group><journal-title>Korean Journal of Urology</journal-title></journal-title-group><issn pub-type="ppub">2005-6737</issn><issn pub-type="epub">2005-6745</issn><publisher><publisher-name>The Korean Urological Association</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21165204</article-id><article-id pub-id-type="pmc">2991581</article-id><article-id pub-id-type="doi">10.4111/kju.2010.51.11.803</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Primary Classic Kaposi's Sarcoma of the Penis in an HIV-Negative Patient</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Kwang Ho</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Joon Il</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Ryu</surname><given-names>Kyoung Ho</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Kang</surname><given-names>In Ho</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Leng</surname><given-names>Yi Hsueh</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Jun Woo</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Jong Woo</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Yoon Jung</given-names></name><xref ref-type="aff" rid="A2">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Lee</surname><given-names>Jeong Ki</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Urology, Seoul Veterans Hospital, Seoul, Korea.</aff><aff id="A2"><label>1</label>Department of Pathology, Seoul Veterans Hospital, Seoul, Korea.</aff><author-notes><corresp>Corresponding Author: Jeong Ki Lee. Department of Urology, Seoul Veterans Hospital, 6-2, Dunchon-dong, Gangdong-gu, Seoul 134-791, Korea. TEL: +82-2-2225-1496, FAX: +82-2-484-4604, <email>urodrljk@yahoo.co.kr</email></corresp></author-notes><pub-date pub-type="ppub"><month>11</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>17</day><month>11</month><year>2010</year></pub-date><volume>51</volume><issue>11</issue><fpage>803</fpage><lpage>806</lpage><history><date date-type="received"><day>05</day><month>7</month><year>2010</year></date><date date-type="accepted"><day>04</day><month>10</month><year>2010</year></date></history><permissions><copyright-statement>Copyright © The Korean Urological Association, 2010</copyright-statement><copyright-year>2010</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0">http://creativecommons.org/licenses/by-nc/3.0</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Kaposi's sarcoma (KS) is a multifocal hemorrhagic sarcoma that occurs primarily on the extremities. KS limited to the penis is rare and a well-recognized manifestation of acquired immune deficiency syndrome (AIDS). However, KS confined to the penis is extraordinary in human immunodeficiency virus (HIV)-negative patients. We present the case of a 68-year-old man with a dark reddish ulcerated nodule on the penile skin, which was reported as a nodular stage of KS. We detected no evidence of immunosuppression or AIDS or systemic involvements in further evaluations. In his past medical history, the patient had undergone three transurethral resections of bladder tumors due to urothelial cell carcinoma since 2000 and total gastrectomy, splenectomy, and adjuvant fluorouracil/cisplatin chemotherapy for 7 months due to advanced gastric carcinoma in 2005. The patient was circumcised and has had no recurrence for 2 years.</p></abstract><kwd-group><kwd>HIV Seronegativity</kwd><kwd>Kaposi sarcoma</kwd><kwd>Penile neoplasms</kwd></kwd-group></article-meta></front><body><p>Kaposi's sarcoma (KS) was introduced by Moritz Kaposi to describe a malignant neoplasm of the vascular endothelium of multifocal origin that occurs primarily on the extremities. Before the acquired immune deficiency syndrome (AIDS) era, KS was a rare sarcoma that was mainly seen in Mediterranean men. In the early 1980s after the onset of the AIDS epidemic, the incidence of KS increased dramatically throughout the world [<xref ref-type="bibr" rid="B1">1</xref>]. Primary presentation on the penis is rare and it is more often observed in AIDS patients, who usually develop an aggressive form and in whom approximately 2-3% of cases show penile KS lesions as the first manifestation of the disease [<xref ref-type="bibr" rid="B2">2</xref>]. However, KS limited to the penis is extremely rare in human immunodeficiency virus (HIV)-negative patients. We experienced a case of ulcerated nodular KS confined to the penis that was very rare in Korea. Here, we report our case with a review of the literature.</p><sec sec-type="cases"><title>CASE REPORT</title><p>A 68-year-old man with no history of homosexual activity presented with a painless ulcerated dark reddish nodule on the penile shaft noticed 3 months earlier. He had both legs amputated because of a bomb explosion during the Korean War. The patient had undergone three transurethral resections of bladder tumor (TURBTs) due to urothelial cell carcinoma since he visited us with a chief complaint of painless gross hematuria in September 2000. Also, the patient underwent total gastrectomy with splenectomy on account of advanced gastric carcinoma in May 2005 and six treatments of adjuvant fluorouracil (5-FU)/cisplatin chemotherapy from July 2005 to January 2006. On the physical examination, an approximately 1 cm sized nodule with pus-like discharge was evident on the outer layer of the dorsal prepuce and two black discolorations on the glans were obvious. There was no evidence of inguinal lymphadenopathy. The results of routine laboratory investigations and urine examinations were normal. Circumcision including the ulcerated nodule was performed. Purple discoloration and profuse bleeding were evident on the field excised nodule. By histologic examination, the nodule with ulceration was diagnosed as the nodular stage of KS. Histologic findings showed an infiltration composed of spindle cells scattered between collagen bundles and small vascular proliferation. Slit-like spaces containing red cells with marked nuclear pleomorphism and mitoses were observed. Immunohistochemical investigations revealed a vascular tumor because of reasonable positivity for vascular markers such as CD31 and CD34, and immunohistochemical staining confirmed KS by diffuse nuclear staining of human herpesvirus type 8 (HHV-8) latent nuclear antigen 1 (LNA-1) (<xref ref-type="fig" rid="F1">Fig. 1</xref>).</p><p>At the repeat physical examination, we found no other skin lesions. We performed additional local excision of two black discolorations on the glans. However, they were reported as keratosis. Repeated HIV tests (enzyme-linked immunosorbent assay and Western blot) were negative. Computed tomography scanning of the chest, abdominal cavity, and pelvis failed to detect any visceral lesions. A 2-year follow-up did not show any disease progression or recurrence from May 2008 to June 2010.</p></sec><sec sec-type="discussion"><title>DISCUSSION</title><p>KS is a tumor of the reticuloendothelial system and thus it is vasoformative with endothelial proliferation and spindle cell formation on histologic examination. Usually, it presents as a cutaneous neovascular lesion; a raised, painful, bleeding papule; or ulcer with bluish discoloration. KS is subcategorized as four types: (1) classic KS, which occurs in patients without known immunodeficiency and has an indolent and rarely fatal course; (2) immunosuppressive treatment-related KS, which occurs in a patient receiving immunosuppressive therapy for organ transplantation or other indications and is often reversed with dosage modification of the immunosuppressive agents; (3) African KS, which occurs in young men and may be indolent or aggressive in course; and (4) epidemic or HIV-related KS, which occurs in patients with AIDS [<xref ref-type="bibr" rid="B3">3</xref>]. In particular, classic KS primarily affects males of Mediterranean or Eastern European descent over the age of 60 years [<xref ref-type="bibr" rid="B4">4</xref>].</p><p>In a recent report, localized classic KS of the glans penis was reported to be rare with only 51 cases reported; 38 cases among them were regarded as isolated classic KS without any association with AIDS or immunosuppression [<xref ref-type="bibr" rid="B4">4</xref>]. However, the majority of cases of primary penile KS reported before the introduction of HIV testing are difficult to classify [<xref ref-type="bibr" rid="B2">2</xref>]. In patients with classic KS, primary penile lesions usually present as a single reddish-purple to bluish nodule, and other clinical presentations are less common. In particular, ulcerative nodules have been described in only two patients. The most frequently involved site is the glans, occasionally in association with swelling and lymphatic edema because of severe involvement. Lesions may also involve the foreskin, the coronal sulcus, or the meatus. However, involvement of the shaft is rare and it is usually associated with lesions located on the glans or coronal sulcus [<xref ref-type="bibr" rid="B2">2</xref>]. Histologic characteristics of penile KS are similar to those of KS at other skin sites. In KS, cells that normally line small blood vessels proliferate in an abnormal way, extending outward from what would have been the lining of the vessel to penetrate between and partially surround nearby collagen bundles, thus creating 'stellate' and 'ectatic' blood vessels that are not closed off but rather are open to surrounding tissue [<xref ref-type="bibr" rid="B5">5</xref>]. Usually, it includes a sometimes branching, irregular, slit-like vascular space containing erythrocytes in the patch stage and prominent groups or sheets of proliferating spindle cells in the nodular stage [<xref ref-type="bibr" rid="B6">6</xref>].</p><p>The pathogenesis of KS is uncertain. Recent studies showed an association between all types of KS and infection of human herpesvirus type 8 (HHV-8), known as KS-associated herpes virus (KSHV) [<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B4">4</xref>,<xref ref-type="bibr" rid="B7">7</xref>-<xref ref-type="bibr" rid="B10">10</xref>]. HHV-8 as a potential oncogenic virus is supported by its tight relationships with primary effusion lymphoma (PEL), its homology with two other oncogenic gamma herpesviruses (herpesvirus saimiri and Epstein-Barr virus), and its ability to alter the growth of human endothelial cells in vitro [<xref ref-type="bibr" rid="B7">7</xref>]. In addition, AIDS-related multicentric Castleman's disease, multiple myeloma, and lymphoma are other neoplastic disorders in which HHV-8 has been commonly found [<xref ref-type="bibr" rid="B8">8</xref>]. Therefore, infection of HHV-8 is a pathogenetic factor in KS considering its potential as an oncogenic virus. It seems that the route of HHV-8 transmission may be both sexual and nonsexual. High HHV-8 seroprevalence in individuals with high-risk sexual activity represents the sexual route, and the detection of HHV-8 antibodies in children without sexual activity suggests the nonsexual route. Zargari reported that saliva could be a potential source of spread of HHV-8 in the general population [<xref ref-type="bibr" rid="B7">7</xref>].</p><p>In our case, only a single, ulcerated dark reddish nodule at the penile shaft near the coronal sulcus was diagnosed as KS. In that KS occurs on the penile shaft with ulceration, this presentation is unusual and a rare form of primary penile KS in an HIV-negative patient. Our patient had undergone treatment for urothelial cell carcinoma and gastric cancer including chemotherapy. However, he presented with KS about 3 years after his last chemotherapy treatment, and his laboratory findings had been normal since his last chemotherapy. Therefore, the KS of our patient seemed to be the classic type. Histologic examination showed a nodule of spindle cells with intracytoplasmic lumina and many mitoses. Immunohistochemical investigations revealed positivity for CD31, CD34, and HHV-8 LNA-1, which is known as a positive marker for KS. The patient vigorously denied sexual activity since his wife died.</p><p>No standard treatment guideline for primary penile KS is available. Treatment includes local surgical excision, radiotherapy, chemotherapy, and laser therapy. Treatment with adjuvant alpha or beta interferon has also been used in some cases. In general, surgical excision is recommended for a small solitary lesion, whereas conservative radiation therapy may be useful for large lesions. Systematic chemotherapy is usually reserved for more advanced cases with visceral involvement or generalized lesions. The clinical course of primary penile KS is variable, and no consistent follow-up data exist. However, local recurrences are rare if the lesion is completely removed. Onset of distant new lesions may be observed after a period of about 1-2 years [<xref ref-type="bibr" rid="B2">2</xref>]. Our patient underwent circumcision including the ulcerated nodule and local excision of black discoloration on the glans. No other adjuvant therapy was performed. He has still not presented with any disease progression or new lesions during a 2-year follow-up.</p><p>In conclusion, primary penile classic KS in HIV-negative patients is rare and is associated with HHV-8 infection. It should be treated aggressively by surgical excision or laser therapy or radiation therapy or chemotherapy because of an uncommon association with systemic involvement.</p></sec></body><back><fn-group><fn fn-type="conflict"><p>The authors have nothing to disclose.</p></fn></fn-group><ref-list><ref id="B1"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gönen</surname><given-names>M</given-names></name><name><surname>Cenker</surname><given-names>A</given-names></name><name><surname>Kiyici</surname><given-names>H</given-names></name><name><surname>Kalkan</surname><given-names>M</given-names></name></person-group><article-title>Penile Kaposi's sarcomas in a circumcised and HIV-seronegative patient</article-title><source>Int J Urol</source><year>2006</year><volume>13</volume><fpage>318</fpage><lpage>320</lpage><pub-id pub-id-type="pmid">16643638</pub-id></element-citation></ref><ref id="B2"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Micali</surname><given-names>G</given-names></name><name><surname>Nasca</surname><given-names>MR</given-names></name><name><surname>De Pasquale</surname><given-names>R</given-names></name><name><surname>Innocenzi</surname><given-names>D</given-names></name></person-group><article-title>Primary classic Kaposi's sarcoma of the penis: report of a case and review</article-title><source>J Eur Acad Dermatol Venereol</source><year>2003</year><volume>17</volume><fpage>320</fpage><lpage>323</lpage><pub-id pub-id-type="pmid">12702076</pub-id></element-citation></ref><ref id="B3"><label>3</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Pettaway</surname><given-names>CA</given-names></name><name><surname>Lynch</surname><given-names>DF</given-names></name><name><surname>Davis</surname><given-names>JW</given-names></name></person-group><person-group person-group-type="editor"><name><surname>Wein</surname><given-names>AJ</given-names></name><name><surname>Kavoussi</surname><given-names>LR</given-names></name><name><surname>Novick</surname><given-names>AC</given-names></name><name><surname>Partin</surname><given-names>AW</given-names></name><name><surname>Peters</surname><given-names>CA</given-names></name></person-group><article-title>Tumors of the penis</article-title><source>Campbell-Walsh urology</source><year>2007</year><edition>9th ed</edition><publisher-loc>Philadelphia</publisher-loc><publisher-name>Saunders</publisher-name><fpage>959</fpage><lpage>991</lpage></element-citation></ref><ref id="B4"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pacifico</surname><given-names>A</given-names></name><name><surname>Piccolo</surname><given-names>D</given-names></name><name><surname>Fargnoli</surname><given-names>MC</given-names></name><name><surname>Peris</surname><given-names>K</given-names></name></person-group><article-title>Kaposi's sarcoma of the glans penis in an immunocompetent patient</article-title><source>Eur J Dermatol</source><year>2003</year><volume>13</volume><fpage>582</fpage><lpage>583</lpage><pub-id pub-id-type="pmid">14721780</pub-id></element-citation></ref><ref id="B5"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schwartz</surname><given-names>RA</given-names></name><name><surname>Cohen</surname><given-names>JB</given-names></name><name><surname>Watson</surname><given-names>RA</given-names></name><name><surname>Gascón</surname><given-names>P</given-names></name><name><surname>Ahkami</surname><given-names>RN</given-names></name><name><surname>Ruszczak</surname><given-names>Z</given-names></name><etal></etal></person-group><article-title>Penile Kaposi's sarcoma preceded by chronic penile lymphoedema</article-title><source>Br J Dermatol</source><year>2000</year><volume>142</volume><fpage>153</fpage><lpage>156</lpage><pub-id pub-id-type="pmid">10651713</pub-id></element-citation></ref><ref id="B6"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lucia</surname><given-names>MS</given-names></name><name><surname>Miller</surname><given-names>GJ</given-names></name></person-group><article-title>Histopathology of malignant lesions of the penis</article-title><source>Urol Clin North Am</source><year>1992</year><volume>19</volume><fpage>227</fpage><lpage>246</lpage><pub-id pub-id-type="pmid">1574814</pub-id></element-citation></ref><ref id="B7"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zargari</surname><given-names>O</given-names></name></person-group><article-title>Exclusive penile Kaposi's sarcoma: report of an HIV-negative man successfully treated with radiotherapy</article-title><source>J Eur Acad Dermatol Venereol</source><year>2006</year><volume>20</volume><fpage>318</fpage><lpage>320</lpage><pub-id pub-id-type="pmid">16503896</pub-id></element-citation></ref><ref id="B8"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chitale</surname><given-names>SV</given-names></name><name><surname>Peat</surname><given-names>D</given-names></name><name><surname>Meaden</surname><given-names>JD</given-names></name><name><surname>Johnson</surname><given-names>HB</given-names></name><name><surname>Burgess</surname><given-names>NA</given-names></name></person-group><article-title>Kaposi's sarcoma of the glans penis in an HIV negative patient</article-title><source>Int Urol Nephrol</source><year>2002</year><volume>34</volume><fpage>251</fpage><lpage>253</lpage><pub-id pub-id-type="pmid">12775106</pub-id></element-citation></ref><ref id="B9"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Morelli</surname><given-names>L</given-names></name><name><surname>Pusiol</surname><given-names>T</given-names></name><name><surname>Piscioli</surname><given-names>F</given-names></name><name><surname>Höfler</surname><given-names>H</given-names></name><name><surname>Weirich</surname><given-names>G</given-names></name><name><surname>Werner</surname><given-names>M</given-names></name><etal></etal></person-group><article-title>Herpesvirus 8-associated penile Kaposi's sarcoma in an HIV-negative patient: first report of a solitary lesion</article-title><source>Am J Dermatopathol</source><year>2003</year><volume>25</volume><fpage>28</fpage><lpage>31</lpage><pub-id pub-id-type="pmid">12544096</pub-id></element-citation></ref><ref id="B10"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>KB</given-names></name><name><surname>Lee</surname><given-names>HS</given-names></name><name><surname>Lee</surname><given-names>HE</given-names></name><name><surname>Park</surname><given-names>SY</given-names></name><name><surname>Chung</surname><given-names>JH</given-names></name><name><surname>Choe</surname><given-names>G</given-names></name><etal></etal></person-group><article-title>Immunohistochemical characteristics of Kaposi sarcoma and its mimicries</article-title><source>Korean J Pathol</source><year>2006</year><volume>40</volume><fpage>361</fpage><lpage>367</lpage></element-citation></ref></ref-list></back><floats-group><fig id="F1" position="float"><label>FIG. 1</label><caption><p>Histopathologic findings. (A) Ulcerated skin (black arrow) with nodule of spindle cells (yellow arrow) (H&E, ×100). (B) Spindle cell proliferation with intracytoplasmic lumina containing red cells (H&E, ×200). (C) Spindle cell proliferation with many mitoses (black arrow) (H&E, ×400). (D) The neoplastic cells are positive for the vascular marker, CD31 (×200). (E) The neoplastic cells are positive for the vascular marker, CD34 (×200). (F) The neoplastic cells are strongly positive for human herpesvirus type 8 latent nuclear antigen 1 (×200).</p></caption><graphic xlink:href="kju-51-803-g001"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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