Esophageal and Gastric Kaposi's Sarcomas Presenting as Upper Gastrointestinal Bleeding

Kaposi's sarcoma (KS) is an uncommon malignant neoplasm of mesenchymal tissue that occurs in immunocompromised patients and people of Mediterranean descent. It is most common in males, and skin lesions are usual presentations. However, visceral lesions are common in organ transplant recipients and involve the gastrointestinal tract. Although the gastrointestinal tract is a site for extracutaneous lesions, most lesions are asymptomatic. Herein, a case of a 41-year-old female with cadaveric renal transplantation and immunosuppressive therapy but without human immunodeficiency virus infection is reported. She was admitted due to tarry stool passage and bilateral neck and inguinal lymph node enlargement. Esophagogastroduodenoscopy revealed multiple grayish-purple plaques in the esophagus and stomach with active oozing from one of the stomach lesions. Histological examination demonstrated characteristic spindle cell stroma and vascular slits with hemorrhage. Furthermore, KS was the impression. The site of gastric bleeding produced by KS was injected locally with bosmin 1:10,000, and heat probe coagulation was performed. No further bleeding was discovered during follow-up. Following modification of the immunosuppressive therapy regimen, the lesions disappeared. (Chang Gung Med J 2002;25:329-33)