© 2005 European Academy of Dermatology and Venereology 603 CASE REPORT JEADV (2005) 19, 603–604 DOI: 10.1111/j.1468-3083.2005.01211.x Blackwell Publishing, Ltd. Sildenafil citrate-aided radiotherapy for the treatment of Kaposi’s sarcoma of the penis TR Ekmekcl,*† M Kendirci,‡ O Kizilkaya,§ A Koslu† †Department of Dermatology, ‡2nd Urology Department, §Department of Radiation Oncology Sisli Etfal Training and Research Hospital, Istanbul, Turkey, *Corresponding author: Ihlamurdere Caddesi No: 153/19, Besiktas/Istanbul Turkey, tel. +90-212-259 20 18; fax +90-212-234 11 21; E-mail: tre@ttnet.net.tr ABSTRACT We report a case of classical Kaposi’s sarcoma involving multiple sites of the penis in a 62-year-old male who was treated with sildenafil citrate-aided electron beam therapy, resulting in complete resolution of the lesions. Keywords: Kaposi’s sarcoma, penis, radiotherapy, sildenafil citrate Received: 3 February 2004, accepted: 7 July 2004 Kaposi’s sarcoma (KS) or multiple idiopathic haemorrhagic sarcomas are vascular neoplasms that occur in four distinct populations: classical KS, African-endemic KS, AIDS-associated KS, and iatrogenic KS. Classical KS confined to the penis is extremely uncommon. 1,2 We present a case of isolated, multiple KS of the penis which has been treated successfully with sildenafil citrate aided electron beam therapy. Case report A 62-year-old circumcised male presented with a 7-month history of asymptomatic lesions on the penis. No history of immunosuppression, intravenous drug addiction, homosexua- lity, and blood transfusion were obtained. Physical examination revealed five nontender, smooth-surfaced, 2-mm purplish papules on the dorsal aspect of the glans penis. Physical examination was otherwise normal and no lymph nodes were palpable in the inguinal regions. Excisional biopsy of one of the lesions showed a proliferation of spindle-shaped cells lining erythrocyte-filled vascular slits and dilated capillaries lined by prominent endothelial cells on the reticular dermis. In addition, occasional lymphocytic infiltration, mitosis, and period acid schiff-positive hyaline globules were also seen. FVIIIAg and CD31 were positive at immunohistochemical staining. The diagnosis was made as KS based on these clinical and histopathological findings. On routine laboratory test, including the ratio of CD4+ to CD8+ and human immunodeficiency virus (HIV) antibody, there were not any abnormalities. Human herpesvirus 8 (HHV-8) IgG antibody was negative. Chest, abdominal, and pelvic computed tomographic scans were completely normal. Initially, the patient was followed-up without any treatment. After 7 months, two new lesions on the corpus penis and one on the glans penis appeared (fig. 1). The lesions on the corpus penis were excised and histopathological examination was also compatible with KS. On the evaluation of sexual status there was moderate erectile dysfunction according to the International Index of Erectile Function (IIEF). Electron beam radiation therapy was applied to five lesions on the glans penis. A total of 20 Gy (2,5 Gy/fraction, fig. 1 Before treatment.