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Kaposi’s Sarcoma of the Penis and Scrotum

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Rare Genitourinary Tumors

Abstract

Kaposi’s sarcoma (KS) is a mesenchymal tumor of blood and lymph vessels associated with infection of human herpesvirus type 8 (HHV-8). Four distinct clinical variants are found including (1) classic, (2) African or endemic, (3) AIDS related or epidemic, and (4) iatrogenic. Commonly affected sites include mucocutaneous surfaces, the oropharynx, genitals, lower extremities, and, in advanced stages, viscera.

For the period 1971–2014, we identified 44 reported cases of penile KS: 6 in HIV-seropositive patients, 29 in HIV-seronegative patients, and 9 patients with unspecified HIV status. Excisional biopsy and histology including intralesional HHV-8 testing were performed in all cases to establish the diagnosis. HIV-seropositive patients had more severe presentations including multiple lesions, ulceration, lesions extending to the groin, and non-discolored nodules. Treatment for these patients included maximizing highly active antiretroviral therapy (HAART). Patients with other clinical variants (HIV negative or unknown) had local treatment performed in 55.3 % (21 out of 38) of cases. Average follow-up was 14.2 months with local recurrence in two cases (2 out of 38, 5.3 %) and distant recurrence in five cases (5 out of 38, 13.2 %). In addition, six case reports of genitourinary KS in HIV-seropositive patients were reported. These cases had more severe presentations including nonpigmented nodules, multiple ulcerated lesions, lesions extending to groin area, deformity of the penis, and urethral stricture. More invasive treatment was attempted in addition to maximizing HAART.

Penile KS is a virus-induced neoplasm affecting primarily men who are HIV positive, have other forms of immunosuppression, or are of Mediterranean or African origin. These subgroups may have different patterns of presentation and require different treatment strategies.

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  1. Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA

    Kimberly A. Maciolek BS, E. Jason Abel MD, FACS, David F. Jarrard MD & Tracy M. Downs MD, FACS

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    Lance Pagliaro

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Maciolek, K.A., Abel, E.J., Jarrard, D.F., Downs, T.M. (2016). Kaposi’s Sarcoma of the Penis and Scrotum. In: Pagliaro, L. (eds) Rare Genitourinary Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-30046-7_22

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