Sequential manifestation of Kaposi’s sarcoma and diffuse large B-cell lymphoma in the context of HIV infection: Case report of a rare presentation

RATIONALE: Kaposi sarcoma (KS) and diffuse large B-cell lymphoma (DLBCL) are AIDS-defining malignancies frequently linked to HIV-related immune dysregulation. Their sequential occurrence in a single patient is an uncommon and clinically significant phenomenon. PATIENT CONCERNS: Herein, we report a case of sequential occurrence of KS and DLBCL that underscores the complex interplay between HIV infection, immune suppression, and oncogenesis. DIAGNOSES: At the time of HIV diagnosis (which prompted the immediate initiation of antiretroviral therapy), the patient, a 46-year-old man, exhibited symptoms (generalized rash, bowel movements) raising clinical suspicion for KS. This was confirmed through clinical examinations, including skin biopsy and colonoscopy. INTERVENTIONS: The patient received treatment with paclitaxel and doxorubicin for KS. One year later, he developed DLBCL, presenting with back and flank pain, and was subsequently treated with the R-CHOP regimen. OUTCOMES: The patient demonstrated a favorable therapeutic response to both treatment regimens. LESSONS: This case underscores the clinical challenges and importance of vigilance in managing sequential AIDS-defining malignancies. It also highlights the need for systematic guidelines for screening oncogenic viruses in HIV-infected individuals, particularly those with prior KS.