Non-cutaneous AIDS-associated Kaposi’s sarcoma presenting as recurrent rectal abscesses

Abstract

Kaposi's sarcoma is a fatal disease that typically presents with cutaneous manifestations in immunocompromised individuals. There are a small number of documented cases where patients diagnosed with this disease present without cutaneous lesions. We present a 35-year-old man with recurrent rectal abscesses and fistula-in-ano, which required multiple drainage procedures. Further investigation revealed a diagnosis of HIV-AIDS, and biopsy of a rectal mass confirmed the diagnosis of visceral Kaposi's sarcoma, despite the absence of cutaneous involvement. Workup revealed hepatic metastasis and a second pulmonary primary malignancy. The patient denied chemotherapy or further intervention and was subsequently lost to follow-up. Prompt diagnosis of Kaposi's sarcoma and initiation of treatment is vital to decrease disease progression. A high index of suspicion should be present in immunocompromised patients, and clinicians must recognise atypical presentations in order to improve long-term survival.

Non-Cutaneous Visceral Kaposi's Sarcoma Diagnosis Confounded by Mycobacterium Avium Complex Lymphadenitis

“…KS is a tumor caused by the growth of infected lymphatic endothelial cells in patients with HHV-8 [ 1 ]. KS is classified into several types, including classic, iatrogenic, endemic, and AIDS-associated, with the latter being the most prevalent [ 9 ]. The presentation may range from mild skin changes to widespread illness affecting internal organs.…”

“…These skin lesions are a hallmark of this vascular tumor. In rare cases, classic KS can present without typical skin lesions, making it difficult to diagnose accurately [ 9 ]. Classic KS mainly affects men and has a male-to-female ratio of 17:1.…”