Radiation Oncology/Sarcoma/EBV-SMT

EBV-Associated Smooth Muscle Tumors (EBV-SMT)

• Hong Kong; 2007 PMID 17446968 -- "Epstein-Barr virus-associated smooth muscle tumor in patients with acquired immunodeficiency syndrome." (Wong KH, J Microbiol Immunol Infect. 2007 Apr;40(2):173-7.)
  • Case report. 2 patients. AIDS. Both tumors EBV+
  • Outcome: 1/2 treated with RT. Both on HAART with stable disease

• Singapore; 2006 PMID 16330945 -- "Epstein-Barr virus-associated smooth muscle tumors are distinctive mesenchymal tumors reflecting multiple infection events: a clinicopathologic and molecular analysis of 29 tumors from 19 patients." (Deyrup AT, Am J Surg Pathol. 2006 Jan;30(1):75-82.)
  • Retrospective. 29 tumors from 19 patients. Mean age 39 years, male > female. Immunosuppression renal transplant (53%), AIDS (42%), steroids (5%). EBV infection confirmed in all cases by FISH. Wide variability in EBV copy number
  • Location: 68% multiple sites; 26% soft tissue, 26% lung, 21% liver, rest miscellaneous.
  • Conclusion: EBV-SMT are histologically distinct from classic soft tissue smooth muscle tumors

• Chulalongkorn University; 2005 (Thailand)(2001-2003) PMID 15844077 -- "Epstein-Barr virus infection-associated smooth-muscle tumors in patients with AIDS." (Suankratay C, Clin Infect Dis. 2005 May 15;40(10):1521-8. Epub 2005 Apr 12.)
  • Retrospective case series. 9 patients with AIDS and SMTs. All CD4 <200. All EBV+. Location: 9 epidural (5 brain, 4 spine), 2 vocal cords, 2 adrenal, 2 abdominal wall, multiple other single sites. 7/9 multicentric
  • Outcome: 3/9 died. 4 patients received RT after surgical resection
  • Conclusion: SMTs in AIDS patients arise in multiple and unusual sites; associated with EBV