Epstein–Barr Virus–associated Multifocal Leiomyosarcomas Arising in a Cardiac Transplant Recipient: Autopsy Case Report and Review of the Literature

Nur, Samina; Rosenblum, Warren D.; Katta, Uma Devi; Islam, Humayun; Brown, Kathy A.; Ramaswamy, Gita

doi:10.1016/j.healun.2007.05.022

Cited by 26 publications

(27 citation statements)

References 19 publications

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“…In four cases (9%) (5,6,18,34), no specific therapy had been performed, including one patient with multiple PTSMT and 60 months survival (6). We found no significant differences in overall survival between surgical resection and reduced immunosuppression without surgery, indicating that both strategies are applicable (Figure 4; Supplementary Table S6).…”

Section: Surgical Resection And/or Immunosuppression Is the Therapy Omentioning

confidence: 79%

“…The femaleto-male ratio was 1:1.2 (no statistical significance) (2-41). The majority of PTSMT developed after kidney transplantation (n = 38/68, 60%) (2,4,6,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) and the site of tumor manifestation was mainly the liver/transplant liver (n = 38/68, 56%) (2,(5)(6)(7)10,11,15,(17)(18)(19)(20)(21)24,25,(27)(28)(29)(30)(31)(33)(34)(35)(36)38,41). PTSMT occurred in a total of 11 transplant Liver (n = 10/68, 15%) Heart (n = 9/68, 13%) Lung (n = 4/68, 6%) Heart + lung (n = 1/68, 2%) Bone marrow (n = 3/68, 4%)…”

Section: Clinical Characteristicsmentioning

confidence: 99%

“…Including our own five patients and data from 40 other case reports (2)(3)(4)(5)(7)(8)(9)(10)(11)(12)14,(17)(18)(19)(21)(22)(23)(26)(27)(28)(29)31,(34)(35)(36)(37)(38)40), we could analyze the morphological details. More than 50% of PTSMT were smaller than 5 cm (median diameter of unifocal tumor or the largest multifocal tumor 4 cm, range 0.8-15 cm).…”

Section: Tumor Morphology and Development Of Ebvmentioning

confidence: 99%

“…It could be expected that most PTSMT which did not manifest in the graft are likely to be of recipient origin. Remarkably, the main site of tumor manifestation was the liver and the transplant liver (2,(5)(6)(7)10,11,15,(17)(18)(19)(20)(21)24,25,(27)(28)(29)(30)(31)(33)(34)(35)(36)38,41). Other solid grafts were less frequently affected; kidney transplants in particular rarely developed PTSMT, although kidneys were the most frequently transplanted organ in all patients with subsequent PTSMT (2,4,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Ptsmt Develop Most Frequently In Donor or Recipient Liversmentioning

confidence: 99%

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Molecular and Clinicopathological Analysis of Epstein-Barr Virus–Associated Posttransplant Smooth Muscle Tumors

Jonigk

Laenger

Maegel

et al. 2012

American Journal of Transplantation

174

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Epstein-Barr virus (EBV)-associated posttransplant smooth muscle tumors (PTSMT)are very rare complications. We aimed to provide a clinicopathological characterization which is based on our own case series (n = 5) as well as previously reported PTSMT cases (n = 63). Meta-analysis of PTSMT and molecular analysis of tumor cells from our cohort was performed. Most PTSMT developed in kidney-transplanted patients (n = 41/68, 60%). Liver/transplant liver was the main site of manifestation (n = 38/68, 56%). Tumors occurred after a median interval of 48 months (range 5-348) and developed earlier in children than in adults. Most tumors showed no marked cellular atypia, low mitosis rate and no tumor necrosis. Gene expression analysis of 20 EBV-related genes, including two microRNAs, revealed overexpression of MYC (p = 0.0357). Therapy was mainly based on surgical resection or reduced immunosuppression but no significant differences in overall survival were evident. Lower overall survival was associated with multiorgan involvement (n = 33/68, 48.5%) and particularly with intracranial PTSMT manifestation (n = 7/68, 10%; p < 0.02), but not transplant involvement (n = 11/68, 16%). In summary, PTSMT differ from conventional leiomyosarcomas by their lack of marked atypia, unusual sites of involvement and defining EBV association. Surgery and reduced immunosuppression show comparable clinical results and prognosis is associated with intracranial manifestation.

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Section: Surgical Resection And/or Immunosuppression Is the Therapy Omentioning

confidence: 79%

Section: Clinical Characteristicsmentioning

confidence: 99%

Section: Tumor Morphology and Development Of Ebvmentioning

confidence: 99%

Section: Ptsmt Develop Most Frequently In Donor or Recipient Liversmentioning

confidence: 99%

See 2 more Smart Citations

Molecular and Clinicopathological Analysis of Epstein-Barr Virus–Associated Posttransplant Smooth Muscle Tumors

Jonigk

Laenger

Maegel

et al. 2012

American Journal of Transplantation

174

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“…4 Most observations of PTSMT have been in recipients of kidney, liver (or multiviscera including the liver) or heart allografts. [5][6][7][8][9][10][11][12][13] Only 2 cases have been reported of smooth muscle tumors after lung transplant. 1,2 To date, smooth muscle proliferations have been detected in just 1 of 368 patients who have undergone lung transplantation at the "Puerta de Hierro" Hospital in Madrid.…”

Section: Discussionmentioning

confidence: 99%

EBV-associated Hepatic Smooth Muscle Tumor After Lung Transplantation: Report of a Case and Review of the Literature

Salamanca

Massa

2009

The Journal of Heart and Lung Transplantation

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Role of surgery in treating epstein‐barr virus‐associated smooth muscle tumor (EBV‐SMT) with central nervous system invasion: A systemic review from 1997 to 2019

et al. 2021

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Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare subset of spindle cell tumor. The presence of EBV DNA in smooth muscle tumor was first documented in 1994, and the term EBV-SMT was first described in 1995. 1-4 In the past few decades, patients at any age who were diagnosed with EBV-SMT, have been proved to have a strong correlation with immunodeficiency. 5-8 Cases of EBV-SMTs are most commonly correlated to secondary (or acquired) immunodeficiency, and the cases mainly consisted of patients with human immunodeficiency virus (HIV) infection 5,9-12 or with post-organ transplantation (POT) under immunosuppressants, 10,11,13 while a small

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Epstein–Barr Virus–associated Multifocal Leiomyosarcomas Arising in a Cardiac Transplant Recipient: Autopsy Case Report and Review of the Literature

Cited by 26 publications

References 19 publications

Molecular and Clinicopathological Analysis of Epstein-Barr Virus–Associated Posttransplant Smooth Muscle Tumors

Molecular and Clinicopathological Analysis of Epstein-Barr Virus–Associated Posttransplant Smooth Muscle Tumors

EBV-associated Hepatic Smooth Muscle Tumor After Lung Transplantation: Report of a Case and Review of the Literature

Role of surgery in treating epstein‐barr virus‐associated smooth muscle tumor (EBV‐SMT) with central nervous system invasion: A systemic review from 1997 to 2019

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