Complete remission of classical Kaposi’s sarcoma following initiation of hormone therapy for prostate cancer

K aposi's sarcoma (KS) is a rare opportunistic angioproliferative neoplasm caused by infection with human herpesvirus 8. Five epidemiological forms of KS have been characterized: classical KS, endemic KS, iatrogenic KS, AIDS-KS, and KS in men who have sex with men but are not HIV-infected. 1In some instances, KS is associated with immune dysfunction, as in AIDS KS or iatrogenic KS, where immune restoration alone can cure KS.In most cases, classic and endemic KS is an indolent disease, for which systemic treatment is unnecessary.However, for patients experiencing symptoms or aesthetic concerns, local treatments such as excision, radiotherapy, or chemotherapy injections may be required.Agressive forms, with visceral involvement or lymphedema, may develop.Chemotherapy is justified for the treatment of these forms, although the age of the patients, many of whom are old, may limit treatment options.Although the role of hormonal disparities has been evoked in KS pathogenesis as KS is predominantly observed in men, the effect of antiandrogenic treatment on KS has never been evaluated.Our case report illustrated the benefit of antiandrogenic treatment for a prostate cancer on KS progression. CASE REPORTAn 81-year-old man presented with a 13-year history of classical KS.He was of Armenian descent and had no history of HIV infection or immunosuppressive therapy.The initial KS lesions appeared at the age of 68, presenting as violaceous nodules on the feet.Five years later, the patient exhibited erythematous, finely scaly patches and plaques on the trunk and 4 limbs (Fig 1, A andC).Given this atypical clinical presentation, skin biopsies were performed on the abdomen, lumbar area, arm, and thigh.All skin biopsies showed a subtle dissecting vascular proliferation in the dermis, highlighted by nuclear positivity on immunohistochemistry with human herpesvirus 8 (HHV-8) antibody (Fig 1 , E andF ), confirming the diagnosis of KS.There was no visceral involvement on the computed tomography scan of the chest, the abdomen, and the pelvis.Given that the lesions were asymptomatic and stable, it was decided to continue therapeutic abstention with regular clinical monitoring.After 11 years of follow-up, the patient was diagnosed with locally advanced prostatic adenocarcinoma and subsequently underwent focused external beam radiotherapy and antiandrogen hormone therapy.The latter consisted of a combination of subcutaneous triptorelin, a synthetic analog of the