Kaposi sarcoma is one of the
acquired immunodeficiency syndrome (
AIDS) defining diseases.
AIDS-associated
Kaposi sarcoma affects primarily the skin and the lungs. Although gastrointestinal involvement is relatively common, biliary tract involvement has rarely been reported. It has been associated mostly with extension from
liver disease. We describe an uncommon presentation of disseminated
Kaposi sarcoma causing
extrahepatic cholestasis due to extrahepatic biliary tract involvement that resolved after
sphincterotomy with biliary stenting. We present a case of a 35-year-old African American male diagnosed with human immunodeficiency virus (
HIV) infection in 2005. He presented with
AIDS after discontinuation of antiretroviral
therapy for one year, subsequently being diagnosed with systemic
Kaposi sarcoma. He presented with signs and symptoms of obstructive biliary disease, including
jaundice,
abdominal pain,
fatigue, and
fever. We encountered a rare presentation of malignant single extrahepatic biliary
stenosis secondary to biliary
Kaposi sarcoma. The biochemical pattern markedly improved after endoscopic retrograde cholangiopancreatography with
sphincterotomy and stenting. However, and despite the resumption of combined antiretroviral
therapy, deep immunosuppression caused worsening clinical condition and death five months after initial presentation. Certainly, among the multiple etiologies of biliary obstruction in
AIDS,
Kaposi sarcoma is one to consider.