Oculoplastics

48 3 Eyelid Neoplasms

KAPOSI SARCOMA K aposi sarcoma is a vascular neoplasia that can involve multiple systems. It is a rare lesion of the eyelids but, when present, is usu ally associated with a compromised immune system, most commonly HIV disease.

Differential Diagnosis ● Pyogenic granuloma ● Chalazion ● Hemangioma ● Melanocytic nevus Laboratory Tests

● Pathologic evaluation if biopsied ● Evaluation of the immune system if indicated Treatment ● Excision with pathologic evaluation ● Cryotherapy or intralesional chemothera peutic agents may be used for local control of the lesions. ● Radiation treatment for some large lesions Prognosis ● Patients who develop lesions associated with HIV often have a short survival and die from advancement of the HIV disease. ● Patients with primary Kaposi sarcoma may survive for years.

Epidemiology and Etiology ● Age: Any ● Gender: More common in males

● Etiology: Vascular neoplasia is often associ ated with immune compromise in the United States. History ● Rapid growth of lesion may occur. ● Patients most commonly are HIV positive, although other forms of immune compromise may predispose patients to these lesions. Examination ● Elevated dermal lesions that are red or pur ple ( Fig. 3-8 )

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