Disseminated Kaposi Sarcoma With Ocular Involvement: An Unusual Multisystem Case Presentation

Kaposi sarcoma (KS) is an angioproliferative malignancy associated with human herpesvirus 8 (HHV-8) infection, predominantly affecting immunocompromised patients such as those with HIV/AIDS. Despite advances in antiretroviral therapy, KS remains a significant cause of morbidity and mortality in this population, especially when diagnosis or treatment is delayed. Ocular involvement, although rare, can lead to significant functional impairment. We report the case of a 21-year-old HIV-positive female on antiretroviral therapy who presented with extensive cutaneous lesions, facial infiltration, periorbital edema causing visual obstruction, and cervical lymphadenopathy. Histopathologic examination confirmed nodular-stage KS. The patient was staged as T1 I1 S1 according to the AIDS Clinical Trials Group (ACTG) classification, indicating advanced disease. Treatment included continuation of antiretroviral therapy, blood transfusions, and systemic chemotherapy with liposomal doxorubicin. After four cycles, she achieved complete clinical and immunologic remission, with resolution of lesions and restoration of visual function. This case highlights the critical role of early recognition, histopathologic diagnosis, and multidisciplinary management in HIV-associated KS. It also underscores the potential for favorable outcomes with timely and integrated therapy, even in advanced cases with ocular involvement.