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32-Year-Old HIV-Positive Patient with Rapidly Progressive Oral Mucosal Swelling
This case features a 32-year-old HIV-positive patient presenting with rapidly progressive oral mucosal swelling, ultimately diagnosed with Kaposi sarcoma of the oral cavity.
Imaging overview:
Axial, coronal, and sagittal contrast-enhanced CT demonstrates enhancing mucosal-based soft tissue masses involving the hard palate, without aggressive osseous destruction. The distribution and enhancement pattern of the lesions, in the clinical context of HIV-positive status, is characteristic of oral cavity Kaposi sarcoma.
Clinical insight:
Kaposi sarcoma is a vascular neoplasm associated with Human herpesvirus 8 (HHV-8) and has a strong association with HIV/AIDS, representing one of the AIDS-defining malignancies. In the oral cavity, the hard palate is the most common site of involvement, though the gingiva and tongue can also be affected. On CT, lesions appear as enhancing mucosal-based soft tissue masses, typically without aggressive bone destruction in early disease. Kaposi sarcoma is often multifocal and may be accompanied by cutaneous lesions elsewhere, which can aid in clinical diagnosis. Recognition of this entity in an immunocompromised patient with oral mucosal masses is important to prompt appropriate workup and management.
Case courtesy of Pattana Wangaryattawanich, MD, Mayo Clinic Arizona.