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World J Hepatol. Feb 8, 2017; 9(4): 171-179
Published online Feb 8, 2017. doi: 10.4254/wjh.v9.i4.171
Hepatic Kaposi sarcoma: A case report and review of the literature
Brett Van Leer-Greenberg, Abhisake Kole, Saurabh Chawla
Brett Van Leer-Greenberg, Abhisake Kole, Saurabh Chawla, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States
Saurabh Chawla, Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States
Author contributions: Van Leer-Greenberg B and Kole A contributed significantly to manuscript preparation and revision; Van Leer-Greenberg B and Chawla S contributed significantly to conception, interpretation and revision.
Conflict-of-interest statement: No conflicts of interest for all authors in the study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Saurabh Chawla, MD, Assistant Professor of Medicine, Director of Endoscopy, Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Faculty Office Building, 49 Jesse Hill Jr. Drive, Suite 431, Atlanta, GA 30322, United States. saurabh.chawla@emory.edu
Telephone: +1-140-47781684 Fax: +1-140-47781681
Received: August 16, 2016
Peer-review started: August 16, 2016
First decision: October 20, 2016
Revised: November 28, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: February 8, 2017
Processing time: 174 Days and 6.5 Hours
Abstract

Kaposi sarcoma (KS) is an aggressive cancer caused by human herpesvirus-8, primarily seen in immunocompromised patients. As opposed to the well-described cutaneous manifestations and pulmonary complications of KS, hepatic KS is rarely reported before death as most patients with hepatic KS do not manifest symptoms or evidence of liver injury. In patients with acquired immune deficiency syndrome, hepatic involvement of KS is present in 12%-24% of the population on incidental imaging and in approximately 35% of patients with cutaneous KS if an autopsy was completed after their death. Patients with clinically significant hepatic injury due to hepatic KS usually have an aggressive course of disease with hepatic failure often progressing to multi-organ failure and death. Here we report an unusual presentation of acute liver injury due to hepatic KS and briefly review the published literature on hepatic KS.

Keywords: Herpesvirus 8; Acquired immune deficiency syndrome-related Kaposi sarcoma; Acquired immune deficiency syndrome hepatopathy; Human; Kaposi sarcoma

Core tip: Hepatic Kaposi sarcoma (KS) is a clinical presentation that disproportionately affects the human immunodeficiency virus/acquired immune deficiency syndrome (AIDS) population. Up to 34% of patients with AIDS and KS have hepatic involvement. Usually hepatic KS is clinically indolent and diagnosed during autopsy. When clinically significant, hepatic KS presents with evidence of liver injury with elevation in bilirubin and liver enzymes, has characteristic findings on imaging and may progress to liver failure and death. Treatment is indicated in patients with progressive and symptomatic hepatic disease in the absence of other etiologies.