A man with oral lesions, constipation and back pain.

We describe an unusual presentation of disseminated Kaposi sarcoma in a 49-year-old African-American man with AIDS who was admitted to the hospital for constipation and back pain. Magnetic resonance imagings of the thoracic and lumbar spine were grossly abnormal, however, a biopsy of the iliac crest was interpreted as normal. The patient remained a diagnostic enigma until disseminated Kaposi sarcoma was suspected, based on vascular plaque-like lesions observed on his hard palate and right conjunctiva. Slides of the bone biopsy with were stained for human herpes virus-8 (HHV-8) antigen, and were positive. AIDS-related skeletal manifestations of Kaposi sarcoma have been reported in the literature but are infrequent.