Treatment of oral Kaposi sarcoma by sirolimus in renal transplanted children: case report and literature review

Kadriye Ozdemir¹*, Nida Dincel¹, Ebru Yılmaz¹,  Banu Yaman², Gozde Gozuoglu¹ and Sevgi Mir¹

¹Ege University Faculty of Medicine, Department of Pediatric Nephrology, İzmir, Turkey

²Ege University Faculty of Medicine, Department of Pathology, İzmir, Turkey

*Corresponding Author E-mail: kcanturk1@hotmail.com;  Phone: +905056822717

Accepted 07 July, 2014

Abstract

Kaposi Sarcoma is one of the most common neoplasia seen in patients after kidney transplantation. The mean occurrence time for malignant tumors after renal transplantation was reported as 61 months whereas for Kaposi’s sarcoma it was written as 20 months. The etiopathogenesis is poorly understood, mostly dependent on human herpesvirus type 8 (HHV-8) infection. In this study, we reported the occurrence of oral Kaposi’s sarcoma in a pediatric renal transplant patient on the 10^th months after transplantation and complete regression of lesions with well functioning graft, via sirolimus therapy. A 13-year-old boy received a renal graft from a living unrelated donor. On the 10^th months of transplantation, he admitted to hospital with a flat purple lesion of 17x11x3 mm in diameter on his left gum, presenting for 3 weeks. He also had a violaceous macular lesion on anterior one-third of the leg. The patient's HIV antibody repeated twice was negative. The biopsy result of the lesion revealed the diagnosis of KS. Diagnosis of oral Kaposi sarcoma was made. The graft was functioning well and there was no systemic involvement. Cyclosporine A was stopped and sirolimus started. He has been on our follow up for a year without any recurrence and with well functioning graft. In the presented case, we wanted to emphasize importance of the switch to sirolimus in the treatment of Kaposi Sarcoma seen in the early post transplant period.

Keywords: Kaposi Sarcoma, kidney transplantation, sirolimus