後天免疫缺乏症候群相關卡波西氏肉瘤－病例報告及文獻回顧

AIDS-related Kaposi Sarcoma-A Case Report and Literatures Review

曾柏蒼(Bo-Tsang Tseng) ； 陳萬宜(Man-Yee Chan)

《臺灣口腔顎面外科學會雜誌》 32卷4期 (2021/12) Pp. 322-333

摘要

卡波西氏肉瘤為第八型人類皰疹病毒所引起的腫瘤，其特徵是增生的梭狀細胞及血管內皮細胞，合併血管新生、發炎，在臨床上呈現紫紅色外觀。卡波西氏肉瘤原為一種罕見的腫瘤，因為二十世紀後期，後天免疫缺乏症候群盛行率的上升，多數患者口內皆可見此病灶，卡波西氏肉瘤的出現變得更普遍。本案例為一位26歲年輕男性，因前上顎牙齦腫脹、流血持續兩週，至門診求診，理學檢查發現口腔有多處腫脹、深紫色團塊，上肢、前胸也發現多處紫紅色色斑，口腔病灶經切片診斷為卡波西氏肉瘤，後續血液檢查人類免疫缺乏病毒呈現陽性結果。本篇藉由此案例的臨床表現、理學檢查、影像結果，回顧後天免疫缺乏症候群相關卡波西氏肉瘤的口腔評估、鑑別診斷、分期、治療方式等相關文獻。

關鍵字

卡波西氏肉瘤 ； 口腔腫瘤 ； 後天免疫缺乏症候群 ； 人類免疫缺乏病毒 ； 第八型人類皰疹病毒

並列摘要

Kaposi sarcoma is a neoplasm induced by human herpesvirus 8 (HHV-8). The characteristics are proliferative spindle cells and endothelial cells, accompanied with angiogenesis and inflammation. Clinical appearance reveals red-to-purple color. Kaposi sarcoma was originally a rare neoplasm. Because of the increasing in the prevalence of acquired immunodeficiency syndrome in the late 20th century, the lesion was also noted in the oral cavity. Therefore, the presence of Kaposi sarcoma has become more common. A 26-year-old male presented in our outpatient department due to persistent swelling and bleeding of anterior maxillary gingiva. Physical examination showed multiple dark purplish masses over the oral cavity. Multiple red-to-purple macules over upper limbs and anterior chest wall were also noted. The oral lesion was diagnosed as Kaposi sarcoma via biopsy. Subsequent laboratory examination showed HIV positive. Based on the clinical manifestations, physical examination, and imaging results of this case, this article reviews the relevant literature on oral assessment, differential diagnosis, staging, and treatment methods of AIDS-related Kaposi's sarcoma.

並列關鍵字

Kaposi sarcoma ； Oral neoplasm ； Acquired immunodeficiency syndrome ； Human immunodeficiency virus ； Human herpesvirus 8