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Kaposi's sarcoma of the recto sigmoid colon in a patient with HIV infection and a high CD4 count

Kaposi's sarcoma (KS) is a well-recognized, HIV-associated opportunistic tumour, which was first described in 1872 by a Hungarian dermatologist, Moritz Kaposi. It predominantly affects homosexual men and heterosexual patients from Africa infected with HIV. The lesions can arise anywhere in the body but occur more frequently on the skin. Despite a trend towards lower CD4 counts at the time of KS presentation, the use of antiretroviral therapy has been associated with a reduction in mortality compared with the pre-ART era. Prior to the introduction of highly active antiretroviral therapy, 40% of people with KS skin lesions were reported to have lesions in the intestine. Conversely, KS can also develop systemically in the absence of skin lesions. We present a case of KS affecting the distal sigmoid colon and rectum in a patient with a relatively preserved CD4 T-cell count, demonstrating that a less common presentation of KS may occur at any CD4 count.