Lymphedema Associated With Kaposi’s Sarcoma: A Case Report

Öz

Lymphedema is a common but often underemphasized complication of Kaposi’s Sarcoma (KS). During the oncological process, it directly affects patients’ functional capacities, quality of life, and adherence to treatment. The aim of this case report is to demonstrate the clinical and functional outcomes of lymphedema secondary to KS. A 56-year-old male patient was diagnosed with KS and started on systemic chemotherapy and antiretroviral therapy. Doppler ultrasonography revealed no signs of venous insufficiency or thrombosis in the right lower extremity; however, segmental slowing of lymphatic flow and an increase in subcutaneous edema were observed. These findings were evaluated as consistent with lymphatic obstruction. The patient underwent a rehabilitation program consisting of manual lymph drainage, compression therapy, exercise, and skin care for a total of 18 sessions over 6 weeks, three days per week. Each session lasted approximately 45–60 minutes. The exercise program included 30 minutes of brisk walking five days a week, ankle pumping exercises to enhance peripheral circulation, and diaphragmatic breathing (10 repetitions × 3 sets). Lymphedema was assessed using tape measurement for limb circumference, tonometry for skin elasticity, the 6-Minute Walk Test (6MWT) for functional capacity, and the Lymphedema Quality of Life Questionnaire (LYMQOL) for quality of life. The applied rehabilitation program was shown to improve edema control and skin elasticity while simultaneously enhancing the patient’s functional capacity and overall quality of life.

Anahtar Kelimeler

• lymphedema
• Kaposi Sarcoma
• Physiotherapy
• rehabilitasyon

Kapoşi Sarkomu İle İlişkili Lenfödem: Bir Olgu Sunumu

Öz

Lenfödem, Kapoşi Sarkomu’nun (KS) sık karşılaşılan ancak yeterince vurgulanmayan bir komplikasyonudur. Onkolojik süreçte hastaların fonksiyonel kapasitelerini, yaşam kalitesini ve tedaviye uyumunu doğrudan etkiler. Bu olgu sunumunun amacı, KS’ye bağlı gelişen lenfödemin hasta üzerindeki klinik ve fonksiyonel sonuçlarını ortaya koymaktır. 56 yaşında erkek hasta, KS tanısı almış ve sistemik kemoterapi ile antiretroviral tedaviye başlanmıştır. Yapılan Doppler ultrasonografide, sağ alt ekstremitede venöz yetmezlik ve tromboz bulgusuna rastlanmamış; ancak lenfatik akışta segmental düzeyde yavaşlama ve subkutanöz ödem artışı izlenmiştir. Bu bulgular, lenfatik tıkanıklıkla uyumlu olarak değerlendirilmiştir. Hastaya toplamda 6 hafta süren, haftada 3 gün olmak üzere toplam 18 seanslık lenf drenajı, kompresyon tedavisi, egzersiz ve cilt bakımı içeren bir rehabilitasyon programı uygulanmıştır. Seanslar yaklaşık 45-60 dakika sürmüştür. Egzersiz programı: 30 dakika, haftada 5 gün tempolu yürüyüş, ayak bileği çevresinde dolaşımı artırmaya yönelik pompa egzersizleri ve diyaframatik solunum (10 tekrar x 3 set) şeklinde düzenlenmiştir. Lenfödemin değerlendirilmesinde mezura ile çevre ölçümü, cilt esnekliği için tonometre ve fonksiyonel kapasite için 6 Dakika Yürüme Testi (6DYT) yaşam kalitesi için lenfödem yaşamm kalitesi ölçeği LYMQOL kullanılmıştır. Uygulanan rehabilitasyon programı ödem kontrolü ve cilt elastikiyetinde iyileşme sağlayarak aynı zamanda hastanın fonksiyonel kapasitesi ile birlikte yaşam kalitesini artırdığını göstermektedir.

Anahtar Kelimeler

• lenfödem
• kapoşi sarkomu
• fizyoterapi
• rehabilitasyon

Kaynakça

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