Læknablaðið - 15.08.1987, Page 11

LÆKNABLAÐIÐ
195
greindist, og hlutfallið hjá okkur er mun hærra en
við sambærilega rannsókn (9) í Noregi (14,6%).
Tímalengd barksterameðferðar fyrir myndun KS í
þessum hópi var mjög breytileg (2-156 mánuðir),
en allt voru þetta sjúklingar með langvarandi
sjúkdóma, sjá töflu II. Barksterarnir valda
ónæmisbælingu (17) og margir telja að ástand
ónæmiskerfisins ráði mestu um framgang KS (3,
18). Það kom einnig fram í rannsókn okkar að
minnkun barksteraskammta dró í fjórum
tilfellum verulega úr framgangi KS, þó það væri
einungis tímabundið hjá einum sjúklingi.
Kaposisarkmein er ekki algengur fylgikvilli
barksterameðferðar, en rétt gæti verið að leita að
KS í húð hjá sjúklingum, sem fá
barksterameðferð um lengri tíma, einkum eldra
fólki með fótabjúg og einstaklingum, sem eru í
áhættuhópum hvað varðar eyðni.
ÞAKKIR
Þakkir eru færðar læknum Vífilsstaðaspítala,
Jónasi Hallgrímssyni prófessor, Reyni
Valdimarssyni lækni, Hrafni Tuliníus prófessor,
bókavörðum Landspítala, læknum
krabbameinslækningadeildar, Halldóru
Halldórsdóttur læknafulltrúa og Hrefnu
Níelsdóttur ljósmyndara.
SUMMARY
This study describes the clinical and histopathological
findings in 12 cases of Kaposi’s sarcoma diagnosed in
Iceland in the period from November 1983 to October
1986. The cases were retrieved through the files of the
Department of Pathology, University of Iceland, by
computer search. The case material was compared with
the files of the Icelandic Cancer Registry to ensure
complete retrieval of all cases diagnosed in Iceland
during this period. The incidence of KS in Iceland was
found to be 1.38 cases/100,000/year. The material
consisted of two epidemiological groups, classical KS
(42%) and KS associated with immunosuppression by
steroid treatment (58%). Clinical information was
collected by review of hospital records, from the private
physicians and partly by interviews and clinical
examination of the patients. The mean age (78.1 vs. 71.6
years respectively), the sex ratio (4 males/1 female vs. 3
males/4 females) and the histological stages (patch,
plaque, nodule) were different for these groups. The
disease was slowly progressive in all cases and limited to
the skin. Treatment consisted most commonly of local
radiotherapy (75%) and the results were good. Local
excision was successful in two cases with nodular lesions
of the nose and eyelid. Three of the patients had other
malignant tumors, ductal carcinoma of the breast,
occult carcinoma of the prostate and squamous cell
carcinoma of the skin. It is proposed that corticosteroids
may be a contributory factor in causing KS. It is
recommended that the risk of Kaposi’s sarcoma should
be considered, when elderly patients and patients at risk
for acquired immunodeficiency syndrome have to be
treated with immunosuppressive agents.
HEIMILDIR
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