An unusual cause of a parotid mass in an immunocompetent host: classic Kaposi's sarcoma

Kaposi’s sarcoma (KS) is a virally driven vascular tumor that usually has a multifocal origin, with multiple vascular nodules in the skin and other organs, particularly the gastrointestinal tract. Four variants of KS have been described: HIV-related, African, iatrogenic and classic. Primary classic KS of the head and neck is rare in any case, but KS arising in intraparotid lymph nodes, especially with no cutaneous involvement, is exceptionally rare. We report the case of an immunocompetent 71-year-old man who presented with a three-month history of a slowly progressive swelling in the right parotid region. After parotidectomy and histopathological diagnosis of lymph node localization of KS, a thorough dermatological examination did not reveal any skin lesions, and chest and abdominal computed tomography scans, esophagogastroduodenoscopy, and fecal occult blood test were all negative for visceral and other lymph node localizations. We here discuss the peculiarity of the presentation, the differential diagnosis, and the management strategy of such a rare disease.