Abdominal neoplasia with sarcomatoid features as the presenting illness of a patient with a newly diagnosed HIV infection and no AIDS-related disorders. Case report, clinical and diagnostic features, and literature discussion

Abdominal neoplasia with sarcomatoid features as the presenting illness of a patient with a newly diagnosed HIV infection and no AIDS-related disorders. Case report, clinical and diagnostic features, and literature discussion

Authors

  • Roberto Manfredi Department of Medical and Surgical Sciences, “Alma Mater Studiorum” University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Sergio Sabbatani Department of Medical and Surgical Sciences, “Alma Mater Studiorum” University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Eleonora Magistrelli Department of Medical and Surgical Sciences, “Alma Mater Studiorum” University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Maria Lucia Tardio Department of Specialistic, Experimental, and Diagnostic Medicine, “Alma Mater Studiorum” University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy

DOI:

https://doi.org/10.7175/cmi.v8i4.961

Keywords:

Rare solid tumors, Sarcomatoid features, Newly diagnosed HIV infection, Case report, Differential diagnosis

Abstract

We aim to describe a patient with an already advanced HIV infection disclosed for the first time during a complex diagnostic workup, which detected a gross abdominal mass attributable to a poorly differentiated mesenchymal cancer with sarcomatoid features which rapidly led our patient to death, in absence of other potential HIV-associated opportunistic diseases. Although extremely rare and rapidly lethal, our case report underscores the need of all caregivers who follow HIV-infected patients also in the cART era to maintain an elevated attention toward infrequent, unexpected, and clinically atypical solid tumors, in order to ensure a timely diagnosis and management when possible.

References

Manfredi R, Calza L, Chiodo F. Three to seven concurrent AIDS-defining disorders at first hospitalization of AIDS presenters as an unexpected emerging feature during the era of highly active antiretroviral therapy. AIDS 2002; 16: 2356-8; http://dx.doi.org/10.1097/00002030-200211220-00025

EACS, European AIDS Clinical Society. Guidelines version 7.1 November 2014. Available at http://www.eacsociety.org/Portals/0/GUIDELINES/English%20PDF%20-%20Version%207.1.pdf (last accessed December 2014)

Pantanowitz L, Schlecht HP, Dezube BJ. The growing problem of non-AIDS-defining malignancies in HIV. Curr Opin Oncol 2006; 18: 469-78; http://dx.doi.org/10.1097/01.cco.0000239886.13537.ed

Petoumenos K, Kumarasamy N, Kerr SJ, et al. Cancers in the TREAT Asia HIV observational database (TAHOD): a retrospective analysis of risk factors. J Int AIDS Soc 2010; 13: 51; http://dx.doi.org/10.1186/1758-2652-13-51

Shiels MS, Engels EA. Increased risk of histologically defined cancer subtypes in human immunodeficiency virus-infected individuals: clues for possible immunosuppression-related or infectious etiology. Cancer 2012; 118: 4869-76; http://dx.doi.org/10.1002/cncr.27454

Manfredi R, Calza L, Chiodo F. Emerging of dual AIDS associated neoplastic diseases in the era of highly active antiretroviral therapy. Sex Transm Infect 2003; 79: 345-6; http://dx.doi.org/10.1136/sti.79.4.345-a

Micheletti AR, Macedo AC, Silva GB, et al. Benign and malign neoplasias in 261 necropsies for HIV-positive patients in the period of 1989 to 2008. Rev Inst Med Trop Sao Paulo 2011; 53: 309-14

Manfredi R, Fulgaro C, Sabbatani S, et al. Disseminated, lethal prostate cancer during human immunodeficiency virus infection presenting with non-specific features. Open questions for urologists, oncologists, and infectious disease specialists. Cancer Detect Prev 2006; 30: 20-3; http://dx.doi.org/10.1016/j.cdp.2005.10.002

Sabbatani S, Fulgaro C, Latini G, et al. Associated actinomycosis and rhinopharyngeal adenocarcinoma during HIV infection: diagnostic and therapeutic issues. Infez Med 2008; 16: 164-72

Calza L, Beltrami C, Manfredi R, et al. Merkel cell carcinoma in a human immunodeficiency virus-infected patients. Br J Dermatol 2002; 146: 895-8; http://dx.doi.org/10.1046/j.1365-2133.2002.04646.x

Manfredi R, Sabbatani S, Calza L, et al. Bladder carcinoma and HIV infection during the highly active antiretroviral therapy era: a rare, but intriguing association. Two case reports and literature review. Scand J Infect Dis 2006; 38: 566-70; http://dx.doi.org/10.1080/00365540500434653

Manfredi R, Sabbatani S, Fasulo G. HIV-associated early gastric adenocarcinoma successfully cured with surgery, and followed over eight years. Int J STD AIDS 2007; 18: 501-4; http://dx.doi.org/10.1258/095646207781147364

Jaber B, Gleckman R. Tuberculous pancreatic abscess as an initial AIDS-defining disorder in a patient infected with the human immunodeficiency virus: case report and review. Clin Infect Dis 1995; 20: 890-4; http://dx.doi.org/10.1093/clinids/20.4.890

Santamaria-Fres M, Fajardo LF, Sogin ML, et al. Lethal infection by a previously unrecognised metazoan parasite. Lancet 1996; 347: 1797-801; http://dx.doi.org/10.1016/S0140-6736(96)91618-9

Fonquernie L, Meynard JL, Kirstetter M, et al. Pseudotumoral abdominal granuloma concomitant with immune reconstitution after antiretroviral treatment. Presse Med 2000; 29: 186-7

Mbulaiteye SM, Parkin DM, Rabkin CS. Epidemiology of AIDS-related malignancies – an international perspective. Hematol Oncol Clin North Am 2003; 17: 673-96; http://dx.doi.org/10.1016/S0889-8588(03)00048-0

Simard EP, Shiels MS, Bhatia K, et al. Long-term cancer risk among people diagnosed with AIDS during childhood. Cancer Epidemiol Biomarkers Prev 2012; 21: 148-54; http://dx.doi.org/10.1158/1055-9965.EPI-11-0823

Bhatia K, Shiels MS, Berg A, et al. Sarcomas other than Kaposi sarcoma occurring in immunodeficiency: interpretations from a systematic literature review. Curr Opin Oncol 2012; 24: 537-46; http://dx.doi.org/10.1097/CCO.0b013e328355e115

McClain KL, Leach CT, Jenson VV, et al. Association of Epstein-Barr virus with leiomyosarcomas in children with AIDS. N Engl J Med 1995; 332: 12-8; http://dx.doi.org/10.1056/NEJM199501053320103

Suankratay C, Shuangshoti S, Mutirangura A, et al. Epstein-Barr virus infection-associated smooth-muscle tumors in patients with AIDS. Clin Infect Dis 2005; 40: 1521-8; http://dx.doi.org/10.1086/429830

Centanni F, Chiodi E, Gattazzo D, et al. A subcoracoid leiomyoma in a patient with diagnosed AIDS. A case report and review of the literature. Radiol Med 2000; 99: 278-80

Grieger TA, Carl M, Liebert HP, et al. Mediastinal liposarcoma in a patient infected with the human immunodeficiency virus. Am J Med 1988; 84: 366; http://dx.doi.org/10.1016/0002-9343(88)90443-3

Kotrashetti VS, Kale AD, Hallikeremath SR, et al. Intraosseous fibrosarcoma of maxilla in an HIV patient. Arch Iran Med 2012; 15: 59-62

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Published

2014-12-22

Issue

Vol. 8 No. 4 (2014)

Section

Case report

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