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.
Maimaiti et al. (Fri,) studied this question.