THE EVOLUTION OF A VASCULAR TUMOR WITH RAPID METASTASIS IN AN HIV-INFECTED YOUNG PATIENT. PARTICULAR OUTLINES. DIAGNOSIS ISSUES. CASE REPORT

C. Marcaş ¹, C. Cambrea ¹, S. Rugină ¹, M. Ilie ¹, D. Tănase ¹, I. Stancu Creţu ¹, S. Diaconu ¹, I. G. Şerban ¹, L. Vlahopol ¹, E. A Caraveteanu ¹, I. Ghiulendan ^1
1 University of Medicine and Pharmacy, Constanţa, Infectious Diseases Hospital

Abstract

Introduction. Given the limited data on the effect of HAART on the natural history of certain malignant diseases, the therapeutic approach of an HIV-positive patient with neoplasia should be the same as that of an HIV-negative patient. Objectives. We present the case of a young HIV-positive patient with a vascular tumor with visceral metastases with fulminant onset and evolution. Case report. A 19 year-old patient with C3 stage HIV AIDS infection was urgently admitted for intense headache and sudden-onset convulsive seizures. A cerebral CT exam revealed multiple intracranial expansive processes. The patient abruptly developed flaccid paraplegia. An emergency MRI of the thoracolumbar vertebral spine was performed. The patient shortly deceased through altering of the neurologic status and through acute renal failure. An anatomopathologic exam revealed a vascular tumoral mass which compressed the cerebral hemispheres, with intense periosteal reaction. Similar disseminated tumors were identified in the liver, pancreas, kidney. Discussions. All HIV-positive patients with malignant diseases should undergo treatment with HAART combined with the standard oncologic therapy for the given malignant disease. The HIV-positive patients with tumors need to be offered access to the same kind of oncologic treatment as HIV-negative patients, ideally through interdisciplinary consults with infectious diseases physicians, with heightened attention to the possible interactions between chemotherapy and HAART.