Hepatic Kaposi sarcoma: A case report and review of the literature

Abstract

Kaposi sarcoma (KS) is an aggressive cancer caused by human herpesvirus-8, primarily seen in immunocompromised patients. As opposed to the well-described cutaneous manifestations and pulmonary complications of KS, hepatic KS is rarely reported before death as most patients with hepatic KS do not manifest symptoms or evidence of liver injury. In patients with acquired immune deficiency syndrome, hepatic involvement of KS is present in 12%-24% of the population on incidental imaging and in approximately 35% of patients with cutaneous KS if an autopsy was completed after their death. Patients with clinically significant hepatic injury due to hepatic KS usually have an aggressive course of disease with hepatic failure often progressing to multi-organ failure and death. Here we report an unusual presentation of acute liver injury due to hepatic KS and briefly review the published literature on hepatic KS.

Keywords: Herpesvirus 8, Acquired immune deficiency syndrome-related Kaposi sarcoma, Acquired immune deficiency syndrome hepatopathy, Human, Kaposi sarcoma

Core tip: Hepatic Kaposi sarcoma (KS) is a clinical presentation that disproportionately affects the human immunodeficiency virus/acquired immune deficiency syndrome (AIDS) population. Up to 34% of patients with AIDS and KS have hepatic involvement. Usually hepatic KS is clinically indolent and diagnosed during autopsy. When clinically significant, hepatic KS presents with evidence of liver injury with elevation in bilirubin and liver enzymes, has characteristic findings on imaging and may progress to liver failure and death. Treatment is indicated in patients with progressive and symptomatic hepatic disease in the absence of other etiologies.