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Introduction Kaposi's sarcomas have been associated with different conditions of immunosuppression and are also known to be a typical complication of solid organ transplantations. Case presentation We report the case of a 65-year-old Turkish man with a history of heart transplantation 10 months ago who presented for clarification of his dyspnea. The patient had a known history of chronic obstructive pulmonary disease and a smoking history of 40 pack years. Radiologically, three progressively growing intra-pulmonary nodules were detected. The histology was diagnostic for a Kaposi's sarcoma. Visceral and especially primary intra-pulmonary Kaposi's sarcomas are very rare and have been described to have a rather unfavorable prognosis. Conclusions Even with a history suggestive for conventional lung cancer, Kaposi's sarcomas should be considered in patients after transplantation of solid organs. It should be noted that in a minority of cases this tumor exists in the absence of the typical cutaneous lesions.

We present the case of a 26-year-old man with a bland medical history, who presented to the general practitioner because of severe cough and dyspnea. The chest X-ray revealed a massive organ-displacing tumor in the right chest not delineable from the mediastinum. The subsequent needle core biopsy was diagnostic for a mixed germ cell tumor comprising immature teratoma and seminoma. After an initially good response to chemotherapy, tumor markers and tumor size were progressive. The right-sided pneumonectomy revealed an intrapulmonary tumor with cystic and solid components, hemorrhage, and necrosis with a tumor diameter of 18cm. Histology confirmed a teratoma with mature and immature components accompanied by residual seminomatous tumor cells. Despite maximal intensive care, the patient died four weeks after surgery from acute respiratory distress syndrome. We describe this exceptional large intrapulmonary germ cell tumor and discuss the spectrum of such rare tumors.