RARE PRIMARY SMALL BOWEL TUMOR IN THE FORM OF CLASSIC KAPOSI’S SARCOMA: CASE PRESENTATION

  • M. A. Șoitu ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • Elena Neștian ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • C. Botezatu ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; ”Colentina” Clinical Hospital, Bucharest, Romania
  • B. Mastalier ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; ”Colentina” Clinical Hospital, Bucharest, Romania
Keywords: primary intestinal tumor, intestinal Kaposi's Sarcoma, enterectomy, occult gastrointestinal bleeding

Abstract

The small bowel represents a rare site for primary neoplasms, with an incidence of less than 2% of
all that are located in the digestive tract. The early diagnosis of these tumors is often difficult due to
the lack of specificity of the clinical presentation, but it can make a difference in matters of 5-year
survival rates: 83% (early detection) versus 14% (late detection). We present the case of a male
patient, aged 66, with an apparently benign jejunal ulcer diagnosed endoscopically. Clinical
presentation: diffuse abdominal pain, fatigability, melena; paraclinical evaluation: anemia,
positive occult gastrointestinal bleeding test, superior and inferior endoscopy without
hemorrhagic lesions. The surgical exploration guided by intramucosal dye discovers a 2 cm
tumor, 250 cm distal to the angle of Treitz with multiple mesenteric adenopathies. Segmental
resection is performed keeping oncological safety margins with the removal of the lymphatic
drainage elements. The postoperative evolution is favorable and leads to complete healing. The
histopathological assay finds pathological changes consistent for Kaposi’s sarcoma and confirms
the presence of HHV-8 in the nuclei of the tumor cells by means of immunohistochemistry. At the
examination of the skin, multiple purple patches were discovered. The particularity of this case is
that the Kaposi’s sarcoma manifests itself in the absence of an immunosuppressive treatment or an
immunodeficiency state induced by an HIV infection. Although rare, the small intestine tumors
should be considered when non-specific abdominal pain is accompanied by positive occult bleeding
test, with scarce endoscopic evidence. Since the Kaposi’s sarcoma is a highly angiogenic tumor, it
is prudent to include it in the differential diagnosis when suspecting a source of gastrointestinal
bleeding.

Published
2018-12-19
How to Cite
[1]
M. Șoitu, E. Neștian, C. Botezatu, and B. Mastalier, “RARE PRIMARY SMALL BOWEL TUMOR IN THE FORM OF CLASSIC KAPOSI’S SARCOMA: CASE PRESENTATION”, JSS, vol. 5, no. 3, pp. 153-160, Dec. 2018.
Section
Articles