Nonepidemic Kaposi sarcoma in a young man

Kaposi sarcoma (KS) is an angioproliferative tumour with four widely recognized epidemiological forms: endemic, epidemic, iatrogenic and classic. However, the increasing evidence of KS in human immunodeficiency virus (HIV)-seronegative men who have sex with men (MSM) has led to the recent appearance of a new category, nonepidemic KS. Nonepidemic KS is still unknown by many physicians and may lead to a notable anxiety to the patient and unnecessary explorations. Our aim was to reflect this reality and raise awareness of the existence and peculiarities of this new variant. We report a case of a KS diagnosed in a young HIV-negative man, previously managed with a notable confusion by other practitioners. The patient had high risk behaviour for infection with KS-associated herpes virus. Repeated negative HIV tests confirmed the diagnosis of nonepidemic KS. Extracutaneous involvement was not suspected. Surgical excision of the tumour was performed, achieving complete response with no relapses in the following months. Nonepidemic KS is a new entity described in young MSM, characterized by few lesions, infrequent visceral involvement and with good prognosis. We emphasize the importance for clinicians to recognize this cutaneous tumour to prompt proper evaluation and better counselling.