Primary nasopharyngeal Kaposi’s sarcoma without cutaneous manifestations: a case report

Abstract

BACKGROUND: Kaposi's sarcoma (KS) is a neoplastic lymphovascular disorder. It typically appears on the skin of the upper and lower extremities, but can also occur on the mucosal surfaces of the head and neck. The most common site reported for head and neck injuries is within the oral cavity, particularly on the palate, and other mucosal sites, such as the nasopharyngeal area. Moreover, involvement of the nasopharynx without skin involvement is even rarer. CASE PRESENTATION: Here, we present a rare case of HIV associated/epidemic KS in a 30-year-old man of African origin, where the primary manifestation was in the nasopharyngeal (NP) area. After the diagnosis, the patient began chemotherapy with the ABV regimen and low-dose radiotherapy, which resulted in clinical improvement and no recurrence during the 6-year follow-up period. CONCLUSION: We have reported the first case of primary nasopharyngeal epidemic Kaposi's sarcoma (KS) in SSA, which presented at an unusual location with atypical features on routine hematoxylin and eosin (H&E) examination and without cutaneous manifestations. The unusually high median survival for this poor-risk epidemic nasopharyngeal KS points to the need to study the natural history of non-cutaneous KS in comparison to other forms of KS that have demonstrated a very dismal survival. This case is highly representative of the complexity of HIV management. The authors aim to bring awareness of the KS's unusual locations and diagnosis challenges.