DOI: 10.12890/2025_005879
Kaposi sarcoma: a case of mistaken identity in an immunocompetent healthy male
Authors
melanie.menning@unmc.edu
Keywords
Kaposi sarcoma, HHV-8, immunocompetent, non-HIV Kaposi sarcomaAbstract
Background: Kaposi’s sarcoma (KS) is a low-grade vascular neoplasm associated with human herpesvirus-8 (HHV-8), frequently occurring in immunocompromised patients, particularly those with human immunodeficiency virus (HIV)Its clinical presentation varies from innocuous-appearing vascular skin lesions to visceral involvement. There are case reports of a rare type of KS which mimics pyogenic granulomas particularly on the feet though reports of KS in immunocompetent, healthy individuals are rare. In this report we share the case of an immunocompetent, healthy young adult male who presented with a lesion concerning for pyogenic granuloma that was found on pathology to be KS.
Case report: We report the case of an HIV-negative, immunocompetent young adult Latin American male who presented with a painful, rapidly growing lesion between his first and second toe. The lesion was initially diagnosed as a wart. After failing salicylic acid and cryotherapy the lesion had a more vascular appearance, as shown in Figure 1. Excisional biopsy was obtained with pathology revealing KS, which was confirmed via latency-associated nuclear antigen (LANA) immunostaining. HIV testing was obtained at three time points, all of which were negative. Patient denied high risk behaviours including sex with men and intravenous drug use. Re-excision for margins was completed with dermatology and pathology again confirmed KS with localized disease. Patient received definitive treatment from dermatology and oncology, emphasizing the multidisciplinary nature of KS management.
Conclusion: KS should be included in the differential diagnosis for vascular lesions particularly involving the feet, even in immunocompetent adults.
References
- Antman K, Chang Y. Kaposi’s sarcoma. N Engl J Med 2000;342:1027–1038. doi: 10.1056/NEJM200004063421407
- Yarchoan R, Uldrick TS. HIV-Associated Cancers and Related Diseases. N Engl J Med 2018;378:1029-1041. doi: 10.1056/NEJMra1615896
- Nguyen T, Beavers C, Hydock A, Brumfield EJ. Non-HIV Kaposi Sarcoma in an Immunocompetent Patient with High-Risk Behavior: Elucidating Subtypes and Risk Factors for Diagnosis. Kans J Med 2023;16:220-221. doi: 10.17161/kjm.vol16.20657
- Grayson W, Pantanowitz L. Histological variants of cutaneous Kaposi sarcoma. Diagn Pathol 2008;3:31. doi: 10.1186/1746-1596-3-31
- Katano H. Pathological Features of Kaposi’s Sarcoma-Associated Herpesvirus Infection. Adv Exp Med Biol 2018;1045:357-376. doi: 10.1007/978-981-10-7230-7_16
- Schneider JW, Dittmer DP. Diagnosis and Treatment of Kaposi Sarcoma. Am J Clin Dermatol 2017;18:529-539. doi: 10.1007/s40257-017-0270-4
- Cesarman E, Damania B, Krown SE, Martin J, Bower M, Whitby D. Kaposi sarcoma. Nat Rev Dis Primers 2019;5:9. doi: 10.1038/s41572-019-0060-9
- Alexander TS. Human immunodeficiency virus diagnostic testing: 30 years of evolution. Clin Vaccine Immunol 2016;23:249–253. doi: 10.1128/CVI.00053-16
