Kaposi sarcoma (KS) is the most common malignancy associated with HIV infection. It usually
affects the skin, the gastrointestinal tract and the lungs. It is generally described in the setting
of CD4 counts < 150 cells/mm3 – 200 cells/mm3. We describe a case of recurrence of KS with a
rare presentation of breast and musculoskeletal involvement in the setting of a CD4 count of
374 cell/mm3 and an undetectable viral load. The patient was on highly active antiretroviral
therapy for 5 years at the time of the second presentation.