Pediatric Genital Endemic Kaposi Sarcoma with Partial Response to Adapalene

Kaposi sarcoma (KS) is a human herpesvirus 8 (HHV-8)-associated vascular neoplasm that most commonly affects immunocompromised individuals. Endemic KS occurs in sub-Saharan Africa but rarely involves the anogenital region in pediatric patients. We report a case of a 12-year-old immunocompetent Ghanaian girl presenting with rapidly progressive nodular and fungating masses involving the trunk and external genitalia. Initial biopsies were reported as squamous papilloma; subsequent histopathologic evaluation with immunohistochemistry confirmed nodular-type KS. The patient demonstrated aggressive disease progression with lymphadenopathy and hepatomegaly, and access to systemic chemotherapy was limited because of financial constraints. Treatment with topical adapalene resulted in rapid resolution of smaller cutaneous lesions. This case highlights diagnostic challenges in resource-limited settings and supports the potential role of topical retinoids as a low-cost palliative therapy for cutaneous KS.