Malignant Tumors

Kaposi Sarcoma

aka KS

Low-grade vascular malignancy caused by HHV-8 (KSHV); oral involvement is a defining lesion of AIDS, typically as purple palatal macules or nodules.

Virus

HHV-8

Site

Hard palate

ART + local therapy

§ figuresFigures (2)

Kaposi Sarcoma — clinical image: This HIV-positive patient presented with an intraoral Kaposi’s sarcoma lesion with an overlying candidiasis infection. This AIDS patient exhibited a CD4+ T-cell count <200, and a high viral load. Initially, the KS les — Fig. 1This HIV-positive patient presented with an intraoral Kaposi’s sarcoma lesion with an overlying candidiasis infection. This AIDS patient exhibited a CD4+ T-cell count <200, and a high viral load. Initially, the KS les
“Kaposi’s sarcoma intraoral AIDS 072 lores” · Photo Credit: Sol Silverman, Jr., D.D.S. Content Providers: CDC/ Sol Silverman, · Public domain · Wikimedia Commons

Kaposi Sarcoma — clinical image: This HIV patient presented with labial and gingival Kaposi’s sarcoma secondary to his AIDS infection which included the maxilla. In approximately 7.5-10 percent of AIDS patients display signs of oral Kaposi’s sarcoma, an — Fig. 2This HIV patient presented with labial and gingival Kaposi’s sarcoma secondary to his AIDS infection which included the maxilla. In approximately 7.5-10 percent of AIDS patients display signs of oral Kaposi’s sarcoma, an
“KaposisSarcomaFromCDC03-18-06” · Photo Credit: Sol Silverman, Jr., D.D.S. Content Providers: CDC/ Sol Silverman, · Public domain · Wikimedia Commons

Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Kaposi Sarcoma figures pending faculty review.

§ overviewOverview

HHV-8-driven mesenchymal malignancy of endothelial origin producing multifocal vascular lesions of skin and mucosa.

§ icdICD Classification

C46

§ etiologyEtiology

01HHV-8 (KSHV) infection
02Cofactor: immunosuppression (HIV, transplant)

§ epidemiologyEpidemiology

AIDS-KS: >20 000× risk vs general population before ART; commonest HIV-associated malignancy.

§ clinicalClinical Features

01Flat red-purple macule → plaque → nodule
02Hard palate most common oral site, then gingiva, tongue
03Multifocal, painless initially → ulceration and bleeding
04Cutaneous, GI, pulmonary involvement in advanced disease

§ differentialDifferential Diagnosis

01Haemangioma
02Pyogenic granuloma
03Melanoma
04Bacillary angiomatosis
05Purpura

§ histopathHistopathology

01Proliferating spindle cells forming slit-like vascular spaces with extravasated RBCs
02Hyaline globules
03Plasma cell infiltrate

§ investigationsInvestigations

01Biopsy with HHV-8 IHC
02HIV testing and CD4 count
03CT chest/abdomen for staging
04Endoscopy if GI symptoms

§ ihcIHC / Special Stains

01HHV-8 LANA-1 positive (diagnostic)
02CD31, CD34, D2-40 positive

§ classificationClassification

01Classic (elderly Mediterranean)
02Endemic (African)
03Iatrogenic (post-transplant)
04AIDS-associated (epidemic)

§ treatmentTreatment

01Optimise ART (mainstay for AIDS-KS)
02Local: intralesional vinblastine, radiotherapy, cryotherapy, sclerotherapy
03Systemic: liposomal doxorubicin, paclitaxel for advanced disease
04Reduce immunosuppression in transplant-related KS

§ complicationsComplications

01Airway obstruction (laryngeal)
02Bleeding, disfigurement
03Systemic dissemination

§ prognosisPrognosis

AIDS-KS: dramatically improved with ART. Classic KS: indolent, elderly-appropriate care.

§ examKey Examination Points

01Purple palatal lesion → biopsy and HIV test
02Assess extent (skin, GI, pulmonary)

§ revisionQuick Revision Summary

01HHV-8 · palate · LANA-1+ · ART + local/systemic therapy

§ vivaBDS Viva Questions

01Aetiological agent of KS?
02Four clinical variants?
03Treatment of AIDS-KS?

§ mcqsMCQs — Assessment (3)

Question 1

Causative virus:

Question 2

Most common oral site:

Question 3

Diagnostic IHC marker:

§ evidenceReferences & Evidence

Current Classification

WHO Classification of Head and Neck Tumours

5th Edition — Volume 9

WHO Classification of Tumours Editorial Board · 2022

The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.

View official source

Evidence summary

Highest level of evidence linked to this page: WHO / Official Classification.

L1 · Classification — 2
L6 · Textbook — 3

1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.

Content last reviewed

September 2026

Evidence last reviewed

September 2026

Next scheduled review

September 2027

Review status

EVIDENCE REVIEWED

Search latest PubMed evidence

Last literature search: 7 September 2026

Open PubMed

Current Classification

Reference #1L1 · ClassificationWHO / Classification Verified

WHO Classification of Head and Neck Tumours5th Edition — Volume 9

WHO Classification of Tumours Editorial Board. IARC / World Health Organization · 2022

The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.

DOI: Identifier not availablePMID: Identifier not available

View source

Reference #2L1 · ClassificationWHO / Classification Verified

WHO Classification of Tumours Online — Head and Neck

IARC / WHO. IARC · 2022

Continuously updated online edition of the WHO head and neck tumour classification.

DOI: Identifier not availablePMID: Identifier not available

View source

Histopathology References

Reference #5L6 · TextbookHistopathology References Unverified

Surgical Pathology of the Head and Neck3rd Edition

Barnes L. CRC Press · 2008