The coexistence of lymphangiosarcoma and Kaposi's sarcoma in a renal transplant recipient

Kaposi's sarcoma was one of the first disorders to be recognized as part of the spectrum of AIDS. This cancer, however, is not limited to AIDS patients, although it is certainly more common among patients with compromised immune function. Kidney transplant recipients fall into this category, and are subsequently at higher risk for Kaposi's sarcoma. Curiously, kidney transplant recipients who develop Kaposi's sarcoma are generally of Jewish and Mediterranean ancestry, just as is the case for classic sporadic Kaposi's sarcoma. The origin and development of Kaposi's sarcoma is uncertain, but it is thought to arise from an endothelial (surface) cell. This origin is similar to that suspected for another cancer, lymphangiosarcoma, which arises from cells of the lymphatic vessels. Therefore, the origin of Kaposi's sarcoma (KS) and lymphangiosarcoma (LS) may be the same, and these two cancers may differ only in the subsequent course of differentiation taken by the cancer. In this light, it is interesting that researchers have found a patient who developed both KS and LS after receiving a kidney transplantation. The patient received a cadaveric kidney in 1971, and skin lesions consistent with KS developed one year later, although they were not recognized as KS at that time. Fourteen years later, the patient developed the blister-like lesions of LS. It is generally believed that the development and progression of LS is slower than that of KS; the different times of onset of symptoms in this patient are consistent with the different rates of development of these two cancers. In the present case, the cancers were very slowly progressive. After recognition of the nature of the patient's skin lesions, treatment with vinblastine was given. The Kaposi's lesions partially resolved and there has been no progression of the lymphangiosarcoma for the year following treatment. The simultaneous occurrence of Kaposi's sarcoma and lymphangiosarcoma lends credence to the notion that these two cancers may arise in the same cells and may differ only in the course of progression of the cancerous cells thereafter. (Consumer Summary produced by Reliance Medical Information, Inc.)