Prevalence of koposi's sarcoma in north of Iraq after the second gulf war 1991

ABSTRACT

Is to show the marked increase in the incidence of Kaposi's sarcoma specially atypical fulminating forms in the north provinces of Iraq after the Second Gulf War 1991. A retrospective comparative study of 404 patients with the diagnosis of Kaposi's sarcoma [372 men and 32 women], their ages ranged between 54 and 75 years, admitted to the surgical and dermatological departments in north provinces from June 1994 till September 2004. The clinical presentation of the patients, hematological and serological investigations, imaging and radiological studies were considered in all the cases. Final diagnosis was established by hitopathological examinations. Patients with the diagnosis of Kaposi's sarcoma were divided into 3 main groups according to the clinical and pathological behavior of the disease Group I, [276 patients, 68.3%] with typical classical type of Kaposi's sarcoma, and group II [116 patients, 28.7%] with atypical fulminating types [lymph-adenopathic; African], and group III [12patients, 1.9%] with immunosuppresion associated [transplant] form of disease were studied. The diagnosis was confirmed by histological examinations of the skin, oral lesions, bronchial and visceral lesions. 44 patients underwent explorative laparotomies and diagnostic laparoscopy because of the dominancy of the abdominal symptoms and signs, 40 of them required more than one surgical intervention because of widespread of the tumor. Local statistical data collected from the tumor registration centers in north of Iraq revealed that the incidence of KS in North of Iraq [Mousl, Erbil, and Dohuk] between years 1980-1990 was 0.6 per 100000 populations, while the incidence became 3.6 per 100000 populations between years 1991-2004 [6 folds increase] after the Second Gulf War 1991. Chest and visceral involvement by KS was extremely rare before nineties, but in the last 10 years the incidence of visceral presentations with a typical fulminating forms of Kaposi's sarcoma was frequent