A man in his mid-50s with previously untreated HIV 1 infection presented with bilateral, violaceous, caruncular lesions. Examination of the left eye showed a violaceous, firm, pedunculated mass protruding nearly 10 mm, extending into the adjacent conjunctiva, and additional eyelid lesions with mild edema (Figure, A). Pathologic examination of similar-appearing oral mucosa lesions showed vascular and spindle cell proliferation with fascicles of atypical spindle cells that stained strongly for human herpesvirus 8, CD31, and erythroblast transformation specific–related gene, confirming a diagnosis of Kaposi sarcoma.1 Further evaluation revealed a CD4 helper T-cell count of 13 cells/μL and bilateral lung and possible liver involvement. The patient started highly active antiretroviral therapy (HAART) and liposomal doxorubicin treatment given the presence of concurrent systemic disease. Nearly 8 months later, examination showed complete regression of bilateral ocular lesions (Figure, B). Ocular Kaposi sarcoma is rarely described as an AIDS-defining illness.2,3 Importantly, active eye disease may be associated with systemic disease.
Huang AM, Larochelle RD, Hink EM. Ocular Kaposi Sarcoma Associated With Systemic Disease and Complete Resolution After Medical Therapy. JAMA Ophthalmol. 2022;140(11):e223945. doi:10.1001/jamaophthalmol.2022.3945
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.