Kaposi Sarcoma Presenting as Retroperitoneal Lymphadenopathy: A Case Report

Kaposi sarcoma is a mesenchymal vascular tumor caused by human gammaherpesvirus 8. Kaposi sarcoma is typically associated with immunocompromise and HIV, and has a classical form seen in elderly men of Mediterranean or Eastern European ethnic origin. We herein present an atypical case of Kaposi sarcoma presenting as retroperitoneal adenopathy in an immunocompetent, non-Mediterranean patient.

A previously healthy 53-year-old patient presented to the emergency department with lower abdominal pain and was found to have isolated retroperitoneal lymphadenopathy on abdominal imaging, later confirmed to be Kaposi sarcoma on biopsy. The patient presented without typical cutaneous findings of Kaposi sarcoma or any risk factors for the disease, including HIV, immunocompromise, or Mediterranean descent. The patient was referred to medical oncology and has had spontaneous regression of adenopathy in the absence of any treatment.

Our review of the case and of the literature demonstrates the many atypical ways in which KS can present. Our case highlights the importance of considering KS in the differential diagnosis for visceral lymphadenopathy in the absence of solid tumor pathology. Lastly, our case brings to light the variable clinical course of KS, which can range from minimal to explosive growth to spontaneous regression.