Disseminated iatrogenic Kaposi sarcoma in an individual with autoimmune hemolytic anemia from India– A rare case report

• Rare case of Iatrogenic Kaposi sarcoma in India with disseminated disease. • This case reports the instance of iKS following corticosteroid therapy for Autoimmune hemolytic anemia. • This case also shows the impact of Liposomal doxorubicin and oral etoposide in regression of lesions, providing therapeutic insights. Kaposi sarcoma is a rare vascular neoplasm associated with Kaposi’s sarcoma-associated Herpesvirus infection. There are four clinical forms of KS, of which Classic and Iatrogenic Kaposi Sarcoma are rare in India. Our patient, a middle-aged woman, presented with generalized lymphadenopathy along with papulonodular skin lesions in the right thigh and gingival mucosa, with an antecedent history of Autoimmune hemolytic anaemia (AIHA) treated with corticosteroids. The histopathology of the lymph node excision revealed a Vaso formative lesion with proliferative spindle cells expressing ERG, CD31, CD34 and Human Herpes virus 8 (HHV8) by immunohistochemistry. The patient was tested seronegative for HIV 1 and 2. Hence, a diagnosis of Kaposi Sarcoma with disseminated mucosal and lymph node metastasis was established. The patient was administered systemic chemotherapy with Liposomal Doxorubicin and is on regular follow-up with no disease progression. We present this case due to its rarity of presentation in an individual of Indian ethnicity preceded by corticosteroid therapy for AIHA for a 6-month duration.