Kaposi Sarcoma with Visceral Involvement in a HIV- Neg Female Patient

Background: Kaposi sarcoma is a rare multifocal malignancy of hemo-lymphatic tissue that ,its precise etiology is unknown .There are reports showing the role for an infective viral agent. In HIV disease ,its prevalence is far more common as well in immune- suppressed patients it is more prevalent. Report of the case: We presented a 78 year- old woman with multiple tender purplish plaques on her extremities for a month. In her past history she was healthy until 2 years ago when she noted two plaques on her left foot and a similar one on her right hand. In skin biopsies, there were spindle shaped cells presented with hypervascularity consistent with Kaposi's sarcoma.She had refused any kind of treatment . No positive signs were found in physical examination. Routine laboratory data was normal. Anti-HIV ab test was negative although she showed significantly lower levels of CD4+ T- lymphocytes in her blood profile. Thoraco-abdominal CT demonstrated lesions highly suggestive of hepato- splenic involvement as multiple hypodense nodules. Because of patient's disagreement and the reluctance of GI surgeons to remove the masse, we refused to refer her for invasive procedures .