MANAGEMENT OF KAPOSIS-SARCOMA

Kaposi's sarcoma (KS) was first described 100 years ago. This tumor of endothelial origin starts in the skin or mucous membranes. The classi cal form is rare, affects elderly persons of Mediterannean origin and is generally indolent. The African variant develops in children and yo ung men, showing an aggressive and usually fatal course. The third var iant of KS affects immunodeficient patients, particularly renal transp lant recipients and HIV-infected persons. The epidemic Kaposi's sarcom a (EKS) is the most common tumor of HIV-infected patients with an inci dence of up to 50%. The cause of EKS still remains to be determined. T he clinical progression of the disease is closely related to the immun ologic defect. This tumor generally appears with multiple skin, oral l esions and/or lymph node involvement. Progressive EKS may infiltrate l ungs and the gastrointestinal tract. Treatment of EKS must take into a ccount the extent of the tumor and debilitating symptoms or tumor-asso ciated severe to life-threatening complications. Therapeutic approache s include local treatment with radiotherapy, intralesional injections of dilute chemotherapy, topical application of liquid nitrogen, laser treatment or systemic therapy with interferon or cytostatic agents. Th e choice of therapy should be based on the specific needs of the indiv idual patient. EKS-associated clinical symptoms, immunological status and other HIV-induced diseases, particularly opportunistic infections, influence the therapeutic decision.