Abstract
Background: Kaposi Sarcoma (KS) is a rare low-grade vascular neoplasm that is associated with Human herpesvirus 8 (HHV-8). KS commonly affects HIV or immunocompromised patients. However, classical KS can be present even in the absence of these factors. In this case report, we describe a case of KS in an 83-year-old, HIV-negative Saudi male who was misdiagnosed for two years. Case Presentation: The patient presented with right foot pain and swelling with two large masses. The patient was initially diagnosed with stasis dermatitis and chronic venous ulcer due to venous insufficiency and treated with endovenous thermal ablation. However, the patient's symptoms did not resolve, and he experienced several episodes of cellulitis that required multiple hospital admissions over a 2-year period. When the patient presented to our center, a biopsy was taken from the lesion, and it confirmed the diagnosis of KS. Conclusion: KS or other underlying etiologies should be suspected in cases of recurrent unresolved infections, particularly in older patients. A high index of suspicion and a low threshold for biopsy are recommended to prevent missed or delayed diagnoses, which could ultimately lead to the worst prognosis.