A 28-year-old previously healthy male presented with 3 months of swelling of the right upper gingiva and lower gingiva and right palate (Figures 1 and 2). He initially presented to dentistry with concern for a tooth abscess and subsequently failed 2 rounds of clindamycin. The patient reported unprotected sexual activity with males and females and endorsed a 13 pack-year smoking history and marijuana use, but denied IV drug use. He underwent biopsy with oral surgery which revealed vascular spindle cell proliferation with local hemosiderin deposition and reactive lymphoplasmacytic infiltration, as well as CD31, CD34, and HHV-8 positivity. During subsequent workup, he was found to be HIV-negative via antigen, antibody, and polymerase chain reaction testing but was found to be hepatitis B positive. An immunodeficiency workup was negative. He was sent to an outside hospital otolaryngologist who repeated the biopsy and confirmed the diagnosis of Kaposi sarcoma (KS) per review by the National Institute of Cancer. He received a course of amoxicillin/clavulanate with slight improvement in the size of the lesions. A complete blood count, chemistry, flow cytometry, as well as upper and lower gastrointestinal endoscopies were within normal limits.