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Publication Date
2024
Keywords
oregon; ppmc; ppmc gme
Disciplines
Hematology | Oncology
Abstract
Introduction: Kaposi’s sarcoma is an AIDS-defining malignancy that is rare in era of widely accessible anti-retroviral therapy (ART), with an incidence of 481 per 100,000 person years. We present a case of a 43-year-old man with HIV/AIDS and disseminated Kaposi’s sarcoma who presented for evaluation of months of worsening dyspnea on exertion which had progressed to dyspnea at rest. Case Presentation: •43-year-old man with a 10 years history of HIV/AIDS, historically non-adherent to ART, who was diagnosed with extensive Kaposi's sarcoma involving the hard palate, airway, and bones one year prior. •He has been treated with ART and doxorubicin chemotherapy since diagnosis with Kaposi’s sarcoma. •He is now presenting to the ED for evaluation of progressive dyspnea. Discussion: •Chylothorax results from compromise of the thoracic duct and leakage of chyle into the pleural space •It is classically considered a rare surgical complication •It can also result from congenital defects, trauma, and invasive metastatic disease •Chylothorax is diagnosed when pleural fluid demonstrates with milky white appearance, high triglycerides, cholesterol, and chylomicrons •Chylothorax is poorly managed with interval thoracenteses or chest tube placement due to ongoing chyle loss •Complications include severe malnutrition and vitamin deficiencies, loss of lymphocytes leading to immunosuppression, pleural effusions causing respiratory distress, fluid depletion, and electrolyte disturbances •Patients are advised to follow a low-fat diet to decrease the amount of chyle production •Chylothorax is best managed with surgical drainage and talc pleurodesis •Chylothorax associated with Kaposi's sarcoma has been reported in a handful of case reports
Area of Special Interest
Cancer
Specialty/Research Institute
Hematology
Specialty/Research Institute
Oncology
