Endemic (African) Kaposi sarcoma: Presenting as pathological fracture of left tibia and fibula

Kaposi sarcoma is a malignant vascular tumour of multifocal origin from undifferentiated vasoformative spindle cell. It presents frequently as cutaneous lesions, and musculoskeletal involvement is rare. Presented is a 52-year-old male farmer with inability to walk and pain of two months duration with cutaneous lesion noticed 3 years prior to presentation. Clinical, radiological and histopathological evaluation revealed cutaneous Kaposi sarcoma with a rare complication of pathological fracture of the left tibia and fibula with dystrophic calcification of the adjoining soft tissue. He had cytotoxic chemotherapy with poor outcome in cutaneous and skeletal lesions. Kaposi sarcoma if neglected presents with significant morbidity. Health promotion on early presentation and diagnosis are recommended for improved outcome.