Rare Presentation of Kaposi Sarcoma Mimicking Madura Foot: A Case Report.

Kaposi sarcoma (KS) is a low-grade angioproliferative tumor primarily associated with HIV but also seen in immunocompetent individuals. Its presentation can mimic infectious diseases such as Madura foot (mycetoma), a chronic granulomatous infection endemic to tropical regions. Accurate diagnosis is critical as management differs significantly between the two. We present a rare case of Kaposi sarcoma in a 40-year-old HIV-negative female initially misdiagnosed as Madura foot. The patient underwent two wide local excisions without improvement. Symptoms persisted until the diagnosis of KS was confirmed, and she was subsequently treated with external beam radiotherapy (EBRT), receiving 45 Gy in 15 fractions, which yielded a good partial clinical and radiological response and significant symptom relief. This case underscores the diagnostic complexities in endemic regions and highlights the importance of distinguishing Kaposi sarcoma from infectious diseases such as Madura foot. It also highlights the role of radiotherapy in managing KS.