Unusual malignant tumours in 49 patients with HIV infection

Silvio Monfardini, Emanuela Vaccher, Giorgio Pizzocaro, Roberto Stellini, Alessandro Sinicco, Sergio Sabbatani, Maurizio Marangolo, Roberto Zagni, Maurizia Clerici, Robin Foà, Umberto Tirelli, Felice Gavosto

Research output: Contribution to journalArticlepeer-review

Abstract

Between December 1986 and December 1988, the Italian Cooperative Group on AIDS-Related Tumours documented 49 HIV-related tumours other than malignant lymphomas (ML) and Kaposi's sarcomas (KS), predominantly among HIV-infected Intravenous drug abusers (IVDA). Of 12 germinal testicular tumours collected, six were seminomas, two of which were pure embryonal and the other four embryonal mixed. Cervical carcinoma was observed In nine IVDAs (intraepithelial in eight and advanced, with rapid progression, in one). Lung cancer associated with HIV Infection was reported In eight patients, of whom four had an adenocarcinoma, two a small cell carcinoma, one an epidermoid carcinoma and one a mesothelioma. All patients with non-small-cell-lung cancer (SCLC) were at stage III, while those with SCLC and mesothelioma had limited disease. Five out of eight presented with limited disease at onset. The median age was low; lung cancer occurred predominantly in young adults, of whom all but one were smokers. Three patients could not be treated; four died while on treatment because of progression of the neoplasia and one died of an overdose. Acute lymphoblastic leukaemia (ALL) was diagnosed in five patients. The lm-munophenotype was always Burkitt-like (L3), and acute myeloblasts leukaemia (M2) was diagnosed in one. Of the central nervous system (CNS) tumours, two cases of glioblastoma and one of medulloblastoma were described. Two cases of young adults with multiple myeloma and two cases of colorectal carcinoma were also reported. One case of chronic lymphocytic leukaemia, one anorectal carcinoma, one oral carcinoma, one pancreatic carcinoma, one thymoma, one kidney carcinoma, one malignant melanoma and thyroid carcinoma were also found. Testis carcinoma occurred mainly in patients In an early phase of HIV Infection, without adversely affecting full-dose chemotherapy or radiotherapy. In situ cervical carcinoma treated with conization would suggest Papanicolaou shear test screening in young IVDA. Lung carcinoma occurred in a young age group with rapid progression and resulted in death within 2 months. Intensive chemotherapy for ALL was not adversely affected by HIV infection and two complete remissions were achieved (11 and 15 months duration). This retrospective study shows that while oral and anorectal tumours were very rarely observed, a wide spectrum of other HIV-related solid tumours and leukaemias were found In this IVDA-based series. The Incidence of such tumours is probably underestimated because they are not diagnostic of AIDS. The required therapeutic approaches may not necessarily be influenced by HIV infection, in contrast with the observed pattern for treatment of KS and ML In HIV-infected subjects.

Original languageEnglish
Pages (from-to)449-452
Number of pages4
JournalAIDS (London, England)
Volume3
Issue number7
Publication statusPublished - 1989

Keywords

  • HIV infection
  • Malignant tumours

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Infectious Diseases

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