Transplant-associated penile Kaposi sarcoma managed with single agent paclitaxel chemotherapy: a case report.
BMC Urol
; 21(1): 87, 2021 Jun 07.
Article
en En
| MEDLINE
| ID: mdl-34098936
ABSTRACT
BACKGROUND:
Kaposi's sarcoma is an uncommon complication in renal transplant patients, and typically presents with cutaneous lesions on the lower extremities. Penile involvement has been reported only rarely. Management of cutaneous-limited disease is primarily reduction of immunosuppression and conversion to an mTOR-inhibitor, whereas the treatment of disseminated disease in transplant patients is more variable. CASE PRESENTATION A 75-year-old male, originally from Somalia, received a deceased-donor kidney transplant for diabetic and hypertensive nephropathy. Seven months post-transplant he presented with lower limb lesions, oedema and bilateral deep vein thromboses. He then developed a fast-growing painful lesion on his penile shaft. A biopsy of this lesion confirmed KS, and a PET scan demonstrated disseminated disease in the lower extremities, penis and thoracic lymph nodes. His tacrolimus was converted to sirolimus, and his other immunosuppression was reduced. He was treated with single agent paclitaxel chemotherapy in view of his rapidly progressing, widespread disease. The penile lesion completely resolved, and the lower extremity lesions regressed significantly. His kidney allograft function remained stable throughout treatment.CONCLUSION:
This case illustrates a rare presentation of an uncommon post-transplant complication and highlights the need for a high index of suspicion of KS in transplant patients presenting with atypical cutaneous lesions. It serves to demonstrate that the use of single agent paclitaxel chemotherapy, switch to an mTORi and reduction in immunosuppression where possible produces excellent short-term outcomes, adding to the body of evidence for this management strategy in disseminated Kaposi's sarcoma.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Pene
/
Complicaciones Posoperatorias
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Sarcoma de Kaposi
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Trasplante de Riñón
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Paclitaxel
/
Antineoplásicos Fitogénicos
Tipo de estudio:
Risk_factors_studies
Límite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
BMC Urol
Asunto de la revista:
UROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Australia