A Unique Case of Metastatic Oral Kaposi Sarcoma in an HIV-Negative Patient

Kaposi's sarcoma (KS) is a tumor involving blood vessels and lymphatic tissue. It is caused by human herpes virus-8, typically in HIV infection in individuals with AIDS. There are 4 major types of KS including classic, endemic, immunosuppression, and AIDS-related. Endemic KS is unique among the different types as it is associated with patients with HIV-seronegative and can present either as an indolent tumor or as a fast-growing mass. The authors discuss a unique presentation of metastatic, endemic KS in a patient with HIV-negative, non-immunosuppression, which has yet to be described in the United States. A 38-year-old male with a history of same-sex partners, presented with a new oral lesion that had appeared 6 weeks ago. He was negative for human papillomavirus or HIV infection. A computed tomography (CT) scan demonstrated destructive lesions of the hard palate. The specimens obtained from biopsy were consistent with endemic KS. A Positron Emission Tomography - computed tomography (PET-CT) scan showed widely-metastatic disease. Case reports have described a rare subtype of HIV-seronegative KS in men who have sex with men. However, these are typically-indolent tumors with exclusively-cutaneous manifestation. This is a unique case of aggressive, widely-metastatic endemic KS metastatic in a patient with HIV-negative.