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Epstein-Barr virus-associated uterine leiomyosarcoma in an adult lung transplant patient
Jan Sunde1, Shilpa Chetty-John, Oksana A Shlobin
1From the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington Hospital Medical Center, Washington, DC and; the Advanced Lung Disease and Transplant Center, Inova Fairfax Hospital, Falls Church, Virginia.
Background:
Multiple viruses have been associated with carcinogenesis in solid-organ transplant patients. Although Epstein-Barr virus (EBV) has been associated with lymphomas in immunocompromised patients, an association with smooth muscle tumors recently has been described.
Case:
An EBV immunoglobulin G-positive woman underwent bilateral lung transplant for sarcoidosis. She was placed on immunosuppression and prophylaxis for opportunistic infections. She presented 5 months later with an EBV-positive uterine leiomyosarcoma. Postoperative therapy included a decrease in immunosuppression and antiviral therapy. Recurrence was noted after 1 year; the patient developed sepsis while undergoing chemotherapy and declined further therapy.
Conclusion:
Epstein-Barr virus-associated leiomyosarcoma can occur in the uterus in immunosuppressed patients.
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