Kaposi sarcoma (KS) is an acquired immunodeficiency syndrome (AIDS)-defining malignancy that can involve the skin, lymph nodes, and visceral organs in patients with advanced human immunodeficiency virus (HIV). We report the case of a 35-year-old man with no known prior medical history who presented to the charity care clinic complaining of recurrent thrush and two weeks of progressive right lower extremity swelling. His physical examination revealed painful, pruritic violaceous papules and plaques over the proximal right thigh that had been present for one week. He was referred to the emergency department (ED) for further workup. Venous duplex ultrasonography was negative for deep venous thrombosis (DVT). He was found to have a newly diagnosed HIV-1 infection with advanced immunosuppression, oral thrush with odynophagia and dysphagia concerning for esophageal candidiasis, and a reactive rapid plasma reagin titer of 1:32 with retinal white dot lesions concerning for ocular syphilis. Computed tomography (CT) demonstrated diffuse right lower extremity soft tissue edema, extensive right inguinal, external iliac, and intrapelvic lymphadenopathy, bilateral axillary lymphadenopathy, and multiple bilateral pulmonary nodules. Punch biopsy of a right thigh lesion revealed KS with tumor cells positive for cluster of differentiation 31 (CD31), CD34, ERG, and human herpesvirus 8 (HHV-8), and an excisional lymph node biopsy demonstrated findings consistent with disseminated KS. Furthermore, cerebrospinal fluid (CSF) analysis confirmed neurosyphilis with a positive Venereal Disease Research Laboratory (VDRL). He was treated with bictegravir/emtricitabine/tenofovir alafenamide, trimethoprim-sulfamethoxazole prophylaxis, fluconazole, and intravenous penicillin G. The patient showed early clinical improvement with resolution of ocular symptoms and a declining HIV viral load following initiation of therapy and before discharge. This case highlights biopsy-proven KS as the presenting manifestation of previously undiagnosed advanced HIV, with unilateral limb lymphedema and pulmonary nodules suggesting disseminated disease. Additionally, our case underscores the need for early HIV testing in patients with recurrent mucocutaneous candidiasis and unexplained lymphedema, and for prompt evaluation of concomitant opportunistic and sexually transmitted infections.

Laparoscopic surgery is a common technique with a minimal risk of consequences for the treatment of gynecological conditions, including uterine leiomyomas. However, in rare instances, serious postoperative complications may occur. We present the case of a 51-year-old patient who underwent a laparoscopic myomectomy without intraoperative complications. The patient experienced acute dyspnea shortly after the surgery, in the absence of other accompanying symptoms. Pneumoperitoneum, pneumomediastinum, and pulmonary embolism (PE) were found during radiological assessment, which included both thoracic and abdominal computed tomography. This case highlights a rare but clinically significant complication that may occur following laparoscopic gynecological surgery, and, to our knowledge, represents the first attempt to suggest a strong association between the coexistence of pneumoperitoneum and pneumomediastinum and PE. Even though venous thromboembolism is still the predominant cause of PE, the potential contribution of perioperative factors warrants further investigation, with the aim of improving the understanding of underlying pathophysiological mechanisms and enhancing patient safety.

This focused systematic review and meta-analysis evaluated robot-assisted inguinal lymphadenectomy (RAIL) versus open inguinal lymph node dissection (OILND) in penile cancer, aiming to provide robot-specific comparative estimates rather than a broad minimally invasive synthesis. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched through December 2025 for comparative studies. All meta-analyses were conducted using STATA 18, employing random-effects modeling. Binary outcomes were summarized using odds ratios (ORs), and continuous outcomes were presented as weighted mean differences (WMDs), with all estimates accompanied by 95% confidence intervals (CIs). Risk of bias in the included non-randomized comparative studies was assessed using the ROBINS-I tool. Four retrospective comparative studies involving 276 patients were included, and no randomized controlled trials were identified. A lower odds of total postoperative complications was observed with RAIL (OR = 0.52, 95% CI: 0.27, 0.97; P = 0.047), but this borderline finding should be interpreted cautiously given the small number of retrospective studies and potential residual confounding. Across individual studies, operative time generally tended to be longer with RAIL, whereas findings for estimated blood loss and drainage-related outcomes were inconsistent. Lymph node yield, skin-related complications, minor complications, and groins with positive nodes did not differ significantly between approaches. According to the GRADE assessment, the certainty of evidence was low for most pooled outcomes and very low for skin-related complications and lower-limb edema/lymphedema. RAIL may be associated with lower overall postoperative complications than open surgery, but the evidence remains low certainty and insufficient to establish a definitive morbidity-reduction benefit. In addition, several continuous perioperative variables showed extreme between-study heterogeneity and were not clinically interpretable as reliable pooled effects.

Primary lymphedema typically manifests as extremity swelling that is chronic, progressive, and incurable. We present a patient with four-limb and facial swelling who was referred for a possible diagnosis of primary lymphedema. The patient eventually was diagnosed with idiopathic spontaneous angioedema. This case highlights distinguishing characteristics between the two disease processes and the importance of recognizing idiopathic spontaneous angioedema on the differential for primary lymphedema.