PD7. Boala Kaposi asociata cu epitelioame cutanate
Prezentam doua cazuri de asociere a bolii Kaposi (BK) cu epitelioame cutanate (un caz cu epiteliomatoza multicentrica) la paciente varstnice (> 70 ani) HIV-negative. Formele histopatologice ale carcinoamelor cutanate au fost la primul caz de tip spinocelular, mixt si bazocelular pe keratoze actinice, iar la al doilea caz de tip bazocelular.
Un grad de imunodepresie a fost obiectivat la primul caz prin prezenta limfopeniei cu discreta scadere CD4, observatie concordand cu studii din literatura, sugerand ca radiatiile UV pot genera imunodepresie la persoane predispuse genetic, favorizand formarea epitelioamelor cutanate.
Tratamentul clasic al BK: Rx-terapie lezionala, Moldamin, (plus chematoterapie citostatica sistemica in primul caz) a asigurat o evolutie partial favorabila, cu recidive si aparitia de noi leziuni in ambele cazuri. Recidive la nivelul leziunilor epiteliomatoase tratate, precum si noi carcinoame cutanate au fost semnalate la primul caz (in decurs de 1 an de la diagnosticare).
Concluzionam ca un grad de imunodepresie a constituit factorul comun favorizant pentru ambele tipuri de neoplazii cutanate, sustinind conexiunea etio-patogenica mai mult decit o asociere intamplatoare.
PD7. Kaposi's Sarcoma associated with cutaneous carcinomas
We present the cases of two female patients HIV negative (age > 70 years) who associated Kaposi's Sarcoma with cutaneous carcinomas (squamous cell carcinoma and basal cell carcinomas).
A light degree of immunodeficiency was noted in the first case (lymphopenia with low CD4 level) accoerding to the data which mention that VV radiation can generate imunosuppresion in persons genetically predisposed, increasing the risc to develop cutaneous carcinomas.
The treatment modalites in KS (superficial X-ray, Benzathin-Peniciline associated with cytotoxic drugs) resulted in partial and temporary tumor reggression. New KS lesions were noted. also new cutaneous carcinomas developed (in the first caseduring the next year).
We conclude that a state of nonspecific immunosuppresion was the common factor which played a critical role in the etiopathogenesis of both types of tumors.