SHM Converge Scientific Abstract ePoster Gallery-Kaposi Sarcoma of the Rectum in Absence of Cutaneous Manifestation

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This case describes a 31-year-old man with advanced HIV/AIDS (CD4 47) and a history of secondary syphilis who presented with worsening rectal pain and recurrent rectal abscesses. He also reported rectal pruritus, nausea, and lower extremity pain. On exam, he had diffuse lymphadenopathy and a small perirectal ulcer, but no classic cutaneous violaceous Kaposi sarcoma lesions.<br /><br />CT imaging showed nonspecific proctitis with rectal wall thickening and perirectal fat stranding. A rectal mass biopsy revealed monomorphic spindle-cell proliferation with slit-like vascular channels containing erythrocytes, and immunostaining was positive for HHV-8, ERG, and CD34, confirming Kaposi sarcoma (KS) of the rectum.<br /><br />The patient was restarted on antiretroviral therapy and referred to infectious disease follow-up. Oncology began rectal radiation and planned systemic chemotherapy with pegylated liposomal doxorubicin and/or liposomal daunorubicin. Palliative care was involved for severe perianal pain control.<br /><br />The report emphasizes that KS is a low-grade vascular tumor associated with HHV-8 and typically presents with skin lesions in immunocompromised patients, but rectal involvement can occur without visible skin disease. In patients with HIV or other immunocompromising conditions, KS should be included in the differential diagnosis of rectal ulcers or lesions, along with hemorrhoids, herpes, syphilis, and condyloma acuminata. Diagnosis requires biopsy, and treatment includes ART plus chemotherapy for advanced disease.

Asset Subtitle

Nicole Robertson

Meta Tag

Author List Nicole Robertson, Sarah Vick

Category Clinical Vignettes

Concept Kaposi Sarcoma

Concept Human Herpesvirus 8

Concept Biopsy

Concept Spindle Cell Proliferation

Concept Vascular Proliferation

Distinguished Finalist

Presenter Organization University of Kentucky College of Medicine

Presenting Author Nicole Robertson

Track Adult

Keywords

Kaposi sarcoma

rectal Kaposi sarcoma

HIV/AIDS

HHV-8

rectal pain

perirectal ulcer

proctitis

biopsy

antiretroviral therapy

chemotherapy

Kaposi Sarcoma

Human Herpesvirus 8

Biopsy

Spindle Cell Proliferation

Vascular Proliferation