EBV-associated smooth muscle tumour presenting as a parapharyngeal mass--a rare presentation

The Epstein-Barr virus-associated smooth muscle tumour (EBV-SMT) is a rare entity that has only recently been recognised. Since its first description in 1993, it has been reported only in immunocompromised patients, and generally presents as one or more non-specific mass lesions which may arise almost anywhere within the body. Because of its sporadic occurrence, non-specific presenting features and frequently unusual sites of occurrence, it often presents a diagnostic challenge for the clinician. We describe an interesting patient with an EBV-SMT which masqueraded as nasopharyngeal carcinoma, presenting with serous otitis media, nasopharyngeal mass and raised Epstein-Barr virus (EBV) serology.