M. Jerbi

Successful Treatment of Kaposi Sarcoma with Triple Visceral Localization After Kidney Transplant

Introduction After kidney transplant, patient infection with human herpesvirus (HH-8) and Kaposi Sarcoma associated herpes virus (KSHV) is known to cause aggressive tumors and severe non-neoplastic complications. KSHV with triple visceral localizations is an unusual form of post transplant Kaposi. No consensus exists on the appropriate treatment of this form of Kaposi Sarcoma. Case report This is a report of a 43-year-old man, who presented with dissemined KSHV and a history of renal transplant. He was transplanted on January 2011,he received Prednisone, Tacrolimus and Micofenolat. Ten months later, he developed a gingival and palatine hypertrophy and skin lesions. The diagnosis of KS was confirmed with pathological evaluations of skin biopsy specimen. Immunosuppression was switched by Sirolimus. We observed a complete regression of both skin and palatine lesions during 4 years. October 2016, he developed triple visceral involvement (one liver,one lung, one pancreas with right leg lymphoedema) while receiving Sirolimus and Prednisone. Visceral disease responded with reduction of immunosuppression and the introduce of chemotherapy with preserved graft function. Conclusion The converting to Sirolimus did not avoid the appearance of visceral localizations of KHSV. This proves that the evolution of KSHV is unpredictable. However,reducing immunossuppression and introducing the chemotherapy was successful in our patient.