Skin cancers are the most common tumors among transplant recipients who receive immunosuppressive agents. KAPOSI sarcoma (KS) is one of the most common malignancies to occur in kidney transplant recipients, especially in the Middle East countries. Its prevalence in comparison with other neoplasms is also relatively higher in Iran (>35%). The KS-associated herpesvirus or human herpesvirus 8 is a newly discovered herpesvirus found in all forms of the KS including those among immunosuppressed transplant recipients. KAPOSI sarcoma usually regresses after withdrawal or reduction of immunosuppressive agents.A wide variety of therapies have been used for KS, including radiotherapy and administration of interferon and different chemotherapeutic regimens. Sirolimus exhibits antiangiogenic activity related to impaired production of vascular endothelial growth factor and limited proliferative response of endothelial cells to the stimulation by vascular endothelial growth factor. Therefore, it can inhibit the progression of KS. Accordingly, replacement of calcineurin inhibitors by a sirolimus can show promising results in the prevention of KS.

Purpose: Newly developed malignancies in kidney transplanted patients are one of the complications attributed to immunosuppression. KAPOSI sarcoma is an unusual malignancy in general population, but may develop in kidney transplanted patients with highly varying prevalence. Our aim is to evaluate the prevalence, clinical manifestations, and outcome of KAPOSI sarcoma in kidney transplanted patients. Material and Method: Five hundred and eighty cases (330 male, 250 female) with a mean age of 38.2 were followed for 36 months (range 9 months to 10 years), visiting every two months. History taking and physical examination with emphasis on skin and mucosa were taken. Biopsy of suspicious skin, mucosal, and visceral lesions assigned by other paraclinical methods was performed Except 7 cases which were HLA identical to donors, all patients were managed with cyclosporine, Azathioprine and Prednisolone. Results: Fourteen patients (2.2%) developed KAPOSI sarcoma (biopsy documented) which constituted 60% of all post - transplantation malignancies. They were 11 males and 3 females with a mean age of 41 years. Sarcoma developed 8 to 31 months after transplantation with and average of 18 months. Of these patients, 13 had skin involvement that one of them had pulmonary involvement too. Another patient had only abdominal involvement. Azathioprine was discontinued in all patients with visceral involvement cyclosporine was discontinued and then chemotherapy was initiated. All 3 patients with visceral involvement did"nt respond to chemotherapy and expired after 6 months. Of 11 patients with skin involvement, one had complete and 2 had incomplete remission of whom, one expired due to acute rejection. Renal function in 8 patients was acceptable, but 2 had impaired renal function, yet did"nt need dialysis. Conclusion: Prevalence of KAPOSI sarcoma in our patients is more than western countries. Visceral involvement is uncommon, but has poor prognosis. Reducing immunosuppression with discontinuation of Azathioprine and significant reducing cyclosporine dosage can cease skin evolvement, with preserving renal function in most of the patients.

We reported two cases of immunocompetent patients with a rare form of AIDS-associated KAPOSI sarcoma (KS), without visceral involvement, presenting with an unusual clinical and histopathological picture called telangiectatic and lymphangioma-like KS, respectively. Dermatologists and pathologists need to be aware of this uncommon described variant to avoid the potential for misdiagnosis.

KAPOSI sarcoma (KS) is the most common cancer after kidney transplantation in the Middle East countries. The prevalence of KS in comparison with other tumors is also quite higher in Iranian recipients.  However, squamous cell carcinoma of the skin is the most common posttransplant malignancy in other reports.  Its incidence following kidney transplantation has steadily increased due to the long-term use of potent immunosuppressive drugs for prevention of allograft rejection.

Introduction: KAPOSI sarcoma and membranous Glomerulonephritis (MGN) is a rare coincidence that has been reported only in one case. Here, we report a case of MGN in relation to KAPOSI sarcoma.Case Report: A 42-year old man referred to our hospital due to severe edema and purple papuleson abdominal skin. Ten months before admission, he had renal biopsy with the report of stage 2 MGN with mesangial proliferation. There were no sign of secondary MGN after complete workup on his first hospital admission. Six months later, patient received Prednisolone (60 mg) and Cyclosporine (300 mg) daily due to rise in serum creatinine and proteinuria. Skin lesions were appeared two months after immunosuppressive therapy. There were erythematous plaques on the skin of abdomen and legs that turned to dark papules gradually. He had 1500 mg/dL proteinuria with hypoalbuminemia andserum creatinine 1.8 mg/dL. Skin biopsy showed KAPOSI sarcoma. Immunosuppressive therapy stopped. There were not any visceral involvements.Skin lesions were spread and became infected. The patient received 6 sessions of chemotherapy with Paclitaxel (Taxol). Four months after chemotherapy he had no complaints. Serum creatinine was 1.1 mg/dL.Conclusions: Although secondary MGN due to malignancies is well established in literature but KAPOSI sarcoma in a patient with MGN is rare coincidence.

Primary KAPOSI sarcoma of penis is very rare. We will introduce a 47 years old male patient referred to our clinic from dermatology service, in this report. The patient suffered from itchy penile papules around coronal region. The lab tests had revealed a negative serology of HIV but tissue PCR was positive for Human Herpesvirus-8 (HHV8). Histological findings were compatible with KAPOSI sarcoma.Primary KAPOSI sarcoma of penis is rare but could occur in HIV negative patients.

After the first description of KAPOSI sarcoma in 1872, many cases of this tumor were reported worldwide. This tumor is multifocal and laryngeal involvement is considered to be as unusual site. KAPOSI sarcoma is almost always are associated with classical skin lesion, and only about 5% of non-acquired immune deficiency syndrome KAPOSI sarcomas are reported to be located in the larynx. We report a kidney transplant recipient diagnosed with solitary laryngeal KAPOSI sarcoma 21 months after transplantation, who was treated with combined surgery, chemotherapy, and immunosuppressive modification.