KAPOSI'S SARCOMA OF MAXILLARAY GINGIVA IN SYSTEMIC LUPUS ERYTHEMATOSUS

전신성 홍반성 낭창 환자에서 상악 치은에 발생한 Kaposi's Sarcoma

  • Kim, Il-Kyu (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Cho, Hyun-Young (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Chang, Keum-Soo (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Park, Seung-Hoon (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Park, Jong-Won (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Sasikala, Balaraman (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Kim, Joon-Mee (Department of Oral and Maxillofacial Surgery, Department of Pathology, College of Medicine, In-Ha University)
  • 김일규 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 조현영 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • ;
  • 박승훈 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 박종원 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 사시카라바라라만 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 김준미 (인하대학교 의과대학 치과학교실 병리과)
  • Published : 2009.07.31

Abstract

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Immunosuppressive type. Epidemic categories is found approximately 20% of all AIDS patients and has strong predilection for head and neck region. The first case of immunosuppresive type Kaposi's sarcoma in patients with kidney transplants was reported in 1969. Kaposi's sarcoma accounts for 5% of all tumors associated with transplanted patients. The most common site of Kaposi's sarcoma in immunosuppressed patients are extremities, but rare in head and neck area. A 42 years old woman who had systemic lupus erythematosus visited to our clinic because of gingival hyperplasia, and excisional biopsy revealed Kaposi's sarcoma. We experienced a case of favorable results using excision and chemotherapy, so we report with review of literatures.

본 증례는 전신성 홍반성 낭창으로 인해 2000년 4월부터 면역 억제제인 azathioprine 75mg과 prednisolne 35mg을 복용 중인 42세 여성 환자가 2004년 12월 상악 협측 치은의 종창, 증식, 동통 및 출혈을 주소로 내원하여 조직 생검 결과 모세 혈관종으로 진단되었으나, 2005년 1월 치은의 재발 병소의 절제 및 조직 생검으로 카포시 육종으로 진단되었고, 흉부의 피부 병변의 조직 생검과 흉부 전산화 단층 촬영 검사에서도 양측 폐에 다수의 결절을 보이는 카포시 육종으로 진단되었다. 의인성 면역억제제에 의한 카포시 육종으로 최종 진단되어, 면역 억제제와 부신피질호르몬제의 중단과, paclitaxel을 이용한 전신적인 항암화학 요법으로, 2008년11월 현재까지 재발의 징후 없이 구강, 피부, 폐의 병소에 대해 양호한 치료 결과를 얻었으나, 향후 전신성 홍반성 낭창의 악화 또는 카포시 육종의 재발 가능성이 있으므로 지속적인 추적 관찰이 요할 것으로 사료된다.

Keywords

References

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