Treatment strategies and palliative care in advanced non-HIV Kaposi’s sarcoma: case study and literature review

Non-HIV Kaposi’s sarcoma is a rare angioproliferative tu­mor with variable progression, but characterized by marked aggressiveness due to its capacity for locoregional re­cur­rence. The therapeutic management of advanced clas­sic Kaposi’s sarcoma (CKS) is challenging because, al­though radiotherapy effectively controls local lesions, the aggressive progression, characterized by frequent lo­co­re­gio­nal recurrences, leads to the inability to administer ef­fec­tive local therapy. Systemic chemotherapy with pegy­la­ted liposomal doxorubicin helps control distant di­sease dissemination, but the therapeutic responses re­main suboptimal. To illustrate the disease progression and locoregional aggressiveness, we present the case of a 76-year-old patient diagnosed with classic Kaposi’s sar­co­ma in 2010, without HIV infection, but with multiple co­mor­bi­di­ties, who, between 2012 and 2024, underwent ra­dio­the­r­apy with an initially favorable response, followed by frequent recurrences. The treatment of advanced CKS re­quires a personalized approach, with radiotherapy re­mai­ning the primary therapeutic strategy, yet frequent re­cur­rences highlight the limitations of current therapies, em­pha­si­zing the importance of palliative care and the need for innovative therapeutic strategies.