HIV-related primary Kaposi's sarcoma of the lower eyelids mimicking a vascular malformation in an otherwise asymptomatic patient

Abstract

A patient presenting with reddish-blue nodules on both the lower eyelids and no other lesion is reported. The nodules were compressible and promptly resumed their original size and shapes upon removing the pressure. At first sight, these lesions were clinically suggestive of a vascular malformation. Carotid angiograms supported this diagnosis. However, the analysis of the serum samples of the patient revealed an underlying HIV infection. Therefore, a diagnosis of Kaposi's sarcoma (KS) was considered as a possibility. Incisional biopsy histology and immunohistochemistry confirmed the diagnosis of KS. In this case, the clinical presentation, the angiography, and the absence of any other symptoms suggestive of an immunodeficient status were clearly misleading and the correct clinical diagnosis was only made possible by the laboratory studies.