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Sarcoma
Volume 2008 (2008), Article ID 859407, 6 pages
http://dx.doi.org/10.1155/2008/859407
Case Report

EBV-Associated Smooth Muscle Neoplasms: Solid Tumors Arising in the Presence of Immunosuppression and Autoimmune Diseases

1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
2Department of Surgery, David Grant United States Air Force Medical Center, Travis Air Force Base, CA 94535, USA
3Department of Surgery, University of California at San Francisco, CA 94143, USA
4Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
5Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA

Received 24 April 2008; Revised 19 August 2008; Accepted 11 October 2008

Academic Editor: Quincy Chu

Copyright © 2008 Kimberly Moore Dalal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Epstein-Barr virus (EBV)-related smooth muscle neoplasms (SMNs) have been associated with immune dysregulation, most notably in patients who have undergone solid organ transplantation or in patients with HIV/AIDS. Objective. to report our experience with EBV-related neoplasms as well as describing the first EBV-related SMN in the setting of administration of glucocorticoids and the tumor necrosis factor inhibitor etanercept. Design. We have case reports, of minimum 3-year follow-up, 2002–2005. Setting. It was held in an academic and tertiary referral cancer center. Patients. Patients are with dysregulated immunity after solid organ transplantation, HIV/AIDS, or with psoriasis after treatment with etanercept. Interventions. There were discontinuation of etanercept, right hepatic trisegmentectomy, and chemotherapy. Measurements. We use survival as a measurement here. Results. Patients who were able to withstand reduction in immunosuppression survived. Surgical resection or chemotherapy was successful in delaying progression of disease. Limitations. There was a relatively short follow-up for these slow-growing neoplasms. Conclusion. EBV-related SMNs have variable aggressiveness. While chemotherapy may slow disease progression, resection and improving the host immune status provide the best opportunity for primary tumor control.