Clinical presentation of non-HIV Kaposi Sarcoma

Kaposi Sarcoma (KS) is a rare entity. In the north west of Pakistan and Afghanistan, we mostly come across non-HIV related Kaposi sarcoma as Human Immunodeficiency Virus (HIV). Infections are rare in this part of the world. Here, we present a case of a non-auto Immunodeficiency Disease (AIDS) related KS. A 45-year-old male, Afghan patient presented to our oncology outpatient's unit with multiple subcutaneous nodules. The sites of involvement were the periorbital region, retro-auricular region, forearms, legs, chest and back. Oral mucosa was spared at the nodules. The patient had no visceromegaly at the time of presentation. A biopsy specimen from the retro-auricular region revealed a KS with dermal lymphatic involvement. His serum was negative for the common types of viral infections including Human Immunodeficiency Virus (HIV) on routine serology. His total B-lymphocytes (CD 19+), total T-lymphocyte (CD3+), total CD4+ lymphocyte (CD3+, CD4+) and total CD8+ (CD3+, CD8+) counts were all normal or borderline high. The patient was under treatment with 3 weekly chemotherapeutic regimens of Adriamycin, Bleomycin, Vincristine (ABV) keeping in view socioeconomical constrains, logistical difficulties in getting proper medical care and side effects of other options like radiotherapy for extended surface areas.