The role of gastrointestinal endoscopy in Kaposi sarcoma

• Published in: Revista española de enfermedades digestivas Vol. 115; no. 12; p. 724
• Main Authors: Gonzalez-Ballesteros, Patricia, de la Mora Levy, José Guillermo, Amaya-Fragoso, Edgardo, Sánchez Jíménez, Beatriz Alejandra
• Format: Journal Article
• Language: English
• Published: Spain Sociedad Espanola de Patologia Digestivas 01-12-2023
• Subjects: Endoscopy, Gastrointestinal; Gastrointestinal Stromal Tumors; Herpesvirus 8, Human; Humans; Prognosis; Sarcoma, Kaposi - diagnosis; Sarcoma, Kaposi - pathology
• ISSN: 1130-0108
• DOI: 10.17235/reed.2023.9534/2023

We are writing to make endoscopists aware of the paramount of a prompt diagnosis of gastrointestinal Kaposi sarcoma (GI-KS). Patients with GI involvement have a two to five times higher risk of death and will benefit from chemotherapy to improve their survival. However, current evidence found that one out of three patients might have a false negative result even with HHV-8 since other entities such as gastrointestinal stromal tumors, angiosarcoma, and lymphoma shared macroscopic and histopathological characteristics. These cause a delay in treatment and significantly worsen the prognosis. We observed a trend for a positive diagnosis from ulcers and nodules. To our knowledge, this is the largest cohort of patients with GI-KS in the world. Our study suggests that in cases where a complete immunochemistry panel for KS is not available, HHV-8 remains as a bare minimum. However, other gastrointestinal lesions shared histopathological characteristics. Therefore, we suggest taking biopsies from nodular and ulcer-type lesions to increase the probability to establish a histopathological diagnosis.