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Classic Kaposi Sarcoma — SCE Dermatology MCQ

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HardSkin CancerClassic Kaposi SarcomaSCE Dermatology

A 76-year-old Mediterranean man has biopsy-confirmed HHV8-positive classic Kaposi sarcoma. Three painful plaques are confined to one lower leg; staging shows no mucosal or visceral disease. Which treatment strategy best matches this extent?

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Correct answer: A — Use local radiotherapy to the symptomatic field and continue surveillance for disease elsewhere

Explanation lettering: B = shown as A · C = shown as B · A = shown as C · E = shown as D · D = shown as E

B is correct. Classic Kaposi sarcoma is often indolent, but painful lesions merit treatment. It is radiosensitive, and local radiotherapy offers high response rates for a limited symptomatic field; surveillance remains necessary because new lesions can develop outside it. Pegylated liposomal doxorubicin is reserved for extensive, rapidly progressive, functionally important or visceral disease. ART treats HIV-associated KS and has no target here. Amputation is disproportionate, while observation alone disregards pain and falsely assumes radioresistance.

Reference: European interdisciplinary Kaposi sarcoma guideline: https://onlinelibrary.wiley.com/doi/full/10.1111/ddg.14788