Document Detail


Kaposi's sarcoma of the pancreas mimicking pancreatic cancer in an HIV-infected patient. Clinical diagnosis by detection of HHV 8 in bile and complete remission following antiviral and cytostatic therapy with paclitaxel.
MedLine Citation:
PMID:  10732297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Diagnosis of pancreatic cancer is usually made by endoscopic retrograde cholangiopancreatography (ERCP) and corresponding findings in computed tomography (CT) or magnetic resonance imaging. Kaposi's sarcoma, a frequent tumor in individuals with a late-stage HIV infection, can be located in the gastrointestinal tract and cause identical symptoms to carcinoma of the same site. A close correlation of this tumor to human herpes virus 8 (HHV 8) has been known for several years and there are reports of successful antiproliferative therapy. METHODS: Aspirated pancreatic juice and bile was investigated for the presence of HHV 8 by polymerase chain reaction. The clinical course of the patient under antiviral therapy and treatment with paclitaxel was studied. RESULTS: A 47-yr-old HIV-infected man with a history of Kaposi's sarcoma of skin and lungs caused by obstructive jaundice in the years before was admitted. ERCP showed a typical double-duct sign and CT revealed a tumorous infiltration of the pancreatic head, highly suspicious for pancreatic adenocarcinoma. A mutation of the ki-ras gene could be ruled out and molecular analysis of bile identified HHV 8 by PCR. Intensive antiviral therapy, including foscarnet and treatment with paclitaxel led to a complete remission within 8 m.o. CONCLUSION: Kaposi's sarcoma of the pancreas possibly mimics pancreatic cancer in HIV-infected subjects. Diagnosis may be made by identification of HHV 8 in pancreatic juice or bile, and successful clinical outcome is possible by intensive antiviral and cytostatic treatment with paclitaxel.
Authors:
M Menges; H W Pees
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of pancreatology : official journal of the International Association of Pancreatology     Volume:  26     ISSN:  0169-4197     ISO Abbreviation:  Int. J. Pancreatol.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-04-11     Completed Date:  2000-04-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703511     Medline TA:  Int J Pancreatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  193-9     Citation Subset:  IM; X    
Affiliation:
Department of Internal Medicine II, University Hospital of the Saarland, Homburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents, Phytogenic / therapeutic use*
Antiviral Agents / therapeutic use*
Bile / virology
Cholangiopancreatography, Endoscopic Retrograde
Diagnosis, Differential
HIV Infections / diagnosis*,  virology
Herpesvirus 8, Human / isolation & purification*
Humans
Male
Middle Aged
Paclitaxel / therapeutic use*
Pancreatic Neoplasms / diagnosis*,  drug therapy*
Radiography, Abdominal
Remission Induction
Sarcoma, Kaposi / diagnosis*,  drug therapy*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Phytogenic; 0/Antiviral Agents; 33069-62-4/Paclitaxel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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