The goal of our study was to verify the effect of complex decongestive therapy (CDT) on malignant lymphedema in 2 patients with Kaposi's sarcoma, classic form, HIV negative, for 3 years.

Material and Methods

Two patients with a 3-year history of lymphedema stage II and III caused by Kaposi's sarcoma (HIV negative, diagnosed by skin biopsy, without visceral injury, manifested on the extremities' skin, TIS classification of low risk) were observed in our study. Besides standard oncologic therapy by Interferon alfa-2a, patients also were treated by CDT, manual lymph drainage, short stretch bandages, pneumatic compression treatment and drug therapy of Wobenzym in a standard dose.

Results

Our study demonstrated mean edema reduction of the lower extremities of 32% and 38% established by computer analysis of extremity volume with circumferential measurements. Reductions of subjective symptoms, measured by a standardized questionnaire, were 25 and 28 points.

Discussion

Classic Kaposi's sarcoma is a systemic vessel tumor of unknown origin with multiple centers and a tendency to ulcerate and erode the skin in the early stages. A slow increase in size can cause plaque formation with obstruction of lymphatic vessels and lymph nodi, and development of malignant lymphedema. It responds well to therapy. An unequivocal opinion in the literature does not exist about CDT in patients with malignant lymphedema manifested by pain, fast development, continuous progression, central localization of swelling initially and rigidity. Two patients with a very good response to therapy and no disease progression were observed in our study.

Conclusion

CDT in Kaposi's sarcoma patients led to reduction of subjective symptoms and objective parameters. No adverse effects of therapy were observed.