Persistently recurring mediterranean Kaposi's sarcoma on skin grafts

Lucia Brambilla, Vinicio Boneschi, Marco Zampieri, Luca Bruognolo, Silvia Fossati

Research output: Contribution to journalArticle

Abstract

In May of 1985, we first saw a 79-year-old woman with Mediterranean Kaposi's sarcoma (KS). It had first appeared in 1983 on the left leg and thigh. In March 1984, the lesions were treated with high-velocity electrons (9MeV) to four contiguous fields (25 x 30 cm, 25 x 30 cm, 12 x 14 cm, and 11 x 14 cm), a total dose of 60 Gy per field, to the left extremity (3rd distal pretibial region, dorsal foot and region of the Achilles tendon). When we first saw the patient, she had a chronic radiodermatitis on the lower third of the left leg, with an extensive and deep ulcer (10 x 15 cm), exposing the tendon insertion of the anterior tibial muscle (Fig. 1). Karposi's sarcoma which had previously regressed after radiotherapy, had also recurred in the form of nodules on the pretibial region along the edge of the ulcer and on the left plantar region. The nodules were treated with intralesional infiltration of vincristine (VCR) according to our usual schedule25 and complete remission (VCR) of all lesions was obtained within 3 months. After the KS nodules disappeared, a successful I total-thickness graft for the ulcer was performed. In April 1987, some biopsy-proven nodules of KS (Fig. 2) appeared on the site of the graft; they regressed within 2 months after local infiltration of VCR. After about 18 months, there were ulcerating flourishing lesions of KS that had developed at the same site (Fig. 3). At this time the lesions were resistant to intralesional treatment, but sensitive to vinblastine (VLB), 9 mg IV, every 4 weeks, with complete remission in March, 1990. In January 1990, a second radiodermatitis ulcer appeared (Fig. 4), confined to the upper margin of the first graft; this required another graft in which a new Kaposi's nodule arose 3 months later (Fig. 5); the nodules regressed after intralesional treatment with VCR. In December 1990, a third ulcer appeared in the region of the left Achilles heel; it was covered with a skin graft that did not survive. In September 1991, the patient was given another graft at the same site with partially favorable results. Three months after the procedure, there was again a KS recurrence in the graft site; this is at present in CR after intralesional treatment with VCR.

Original languageEnglish
Pages (from-to)362-364
Number of pages3
JournalInternational Journal of Dermatology
Volume35
Issue number5
Publication statusPublished - May 1996

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Kaposi's Sarcoma
Vincristine
Transplants
Ulcer
Skin
Radiodermatitis
Leg
Achilles Tendon
Vinblastine
Thigh
Sarcoma
Tendons
Foot
Skeletal Muscle
Radiotherapy
Therapeutics
Extremities
Electrons
Biopsy
Recurrence

ASJC Scopus subject areas

  • Dermatology

Cite this

Brambilla, L., Boneschi, V., Zampieri, M., Bruognolo, L., & Fossati, S. (1996). Persistently recurring mediterranean Kaposi's sarcoma on skin grafts. International Journal of Dermatology, 35(5), 362-364.

Persistently recurring mediterranean Kaposi's sarcoma on skin grafts. / Brambilla, Lucia; Boneschi, Vinicio; Zampieri, Marco; Bruognolo, Luca; Fossati, Silvia.

In: International Journal of Dermatology, Vol. 35, No. 5, 05.1996, p. 362-364.

Research output: Contribution to journalArticle

Brambilla, L, Boneschi, V, Zampieri, M, Bruognolo, L & Fossati, S 1996, 'Persistently recurring mediterranean Kaposi's sarcoma on skin grafts', International Journal of Dermatology, vol. 35, no. 5, pp. 362-364.
Brambilla, Lucia ; Boneschi, Vinicio ; Zampieri, Marco ; Bruognolo, Luca ; Fossati, Silvia. / Persistently recurring mediterranean Kaposi's sarcoma on skin grafts. In: International Journal of Dermatology. 1996 ; Vol. 35, No. 5. pp. 362-364.
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abstract = "In May of 1985, we first saw a 79-year-old woman with Mediterranean Kaposi's sarcoma (KS). It had first appeared in 1983 on the left leg and thigh. In March 1984, the lesions were treated with high-velocity electrons (9MeV) to four contiguous fields (25 x 30 cm, 25 x 30 cm, 12 x 14 cm, and 11 x 14 cm), a total dose of 60 Gy per field, to the left extremity (3rd distal pretibial region, dorsal foot and region of the Achilles tendon). When we first saw the patient, she had a chronic radiodermatitis on the lower third of the left leg, with an extensive and deep ulcer (10 x 15 cm), exposing the tendon insertion of the anterior tibial muscle (Fig. 1). Karposi's sarcoma which had previously regressed after radiotherapy, had also recurred in the form of nodules on the pretibial region along the edge of the ulcer and on the left plantar region. The nodules were treated with intralesional infiltration of vincristine (VCR) according to our usual schedule25 and complete remission (VCR) of all lesions was obtained within 3 months. After the KS nodules disappeared, a successful I total-thickness graft for the ulcer was performed. In April 1987, some biopsy-proven nodules of KS (Fig. 2) appeared on the site of the graft; they regressed within 2 months after local infiltration of VCR. After about 18 months, there were ulcerating flourishing lesions of KS that had developed at the same site (Fig. 3). At this time the lesions were resistant to intralesional treatment, but sensitive to vinblastine (VLB), 9 mg IV, every 4 weeks, with complete remission in March, 1990. In January 1990, a second radiodermatitis ulcer appeared (Fig. 4), confined to the upper margin of the first graft; this required another graft in which a new Kaposi's nodule arose 3 months later (Fig. 5); the nodules regressed after intralesional treatment with VCR. In December 1990, a third ulcer appeared in the region of the left Achilles heel; it was covered with a skin graft that did not survive. In September 1991, the patient was given another graft at the same site with partially favorable results. Three months after the procedure, there was again a KS recurrence in the graft site; this is at present in CR after intralesional treatment with VCR.",
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N2 - In May of 1985, we first saw a 79-year-old woman with Mediterranean Kaposi's sarcoma (KS). It had first appeared in 1983 on the left leg and thigh. In March 1984, the lesions were treated with high-velocity electrons (9MeV) to four contiguous fields (25 x 30 cm, 25 x 30 cm, 12 x 14 cm, and 11 x 14 cm), a total dose of 60 Gy per field, to the left extremity (3rd distal pretibial region, dorsal foot and region of the Achilles tendon). When we first saw the patient, she had a chronic radiodermatitis on the lower third of the left leg, with an extensive and deep ulcer (10 x 15 cm), exposing the tendon insertion of the anterior tibial muscle (Fig. 1). Karposi's sarcoma which had previously regressed after radiotherapy, had also recurred in the form of nodules on the pretibial region along the edge of the ulcer and on the left plantar region. The nodules were treated with intralesional infiltration of vincristine (VCR) according to our usual schedule25 and complete remission (VCR) of all lesions was obtained within 3 months. After the KS nodules disappeared, a successful I total-thickness graft for the ulcer was performed. In April 1987, some biopsy-proven nodules of KS (Fig. 2) appeared on the site of the graft; they regressed within 2 months after local infiltration of VCR. After about 18 months, there were ulcerating flourishing lesions of KS that had developed at the same site (Fig. 3). At this time the lesions were resistant to intralesional treatment, but sensitive to vinblastine (VLB), 9 mg IV, every 4 weeks, with complete remission in March, 1990. In January 1990, a second radiodermatitis ulcer appeared (Fig. 4), confined to the upper margin of the first graft; this required another graft in which a new Kaposi's nodule arose 3 months later (Fig. 5); the nodules regressed after intralesional treatment with VCR. In December 1990, a third ulcer appeared in the region of the left Achilles heel; it was covered with a skin graft that did not survive. In September 1991, the patient was given another graft at the same site with partially favorable results. Three months after the procedure, there was again a KS recurrence in the graft site; this is at present in CR after intralesional treatment with VCR.

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