Epstein-Barr virus-associated smooth muscle tumour mimicking bilateral vocal process granuloma.
A case is presented of a 36-year-old Chinese woman with a renal transplant for end-stage renal failure due to Goodpasture's syndrome. She presented with a year's history of throat discomfort and acid regurgitation into her throat. Videolaryngoscopy revealed bilateral vocal process granuloma, presumed to be due to gastroesophageal reflux. A four-week course of high dose omeprazole was prescribed. On follow up a month later, the granulomas had enlarged, and laser excision was undertaken. Histological and immunohistochemical staining was consistent with Epstein-Barr virus-associated smooth muscle tumour. This is believed to be the first reported case in the English literature of such a tumour affecting the vocal process. The aim of this paper is to present the pathogenesis, clinical behaviour and treatment of Epstein-Barr virus-associated smooth muscle tumour, and to review the literature concerning the differential diagnosis of polypoid vocal process lesions.
Gan
E C
EC
Department of Otolaryngology, Singapore General Hospital, Singapore. ecgan@hotmail.com
Lau
D P C
DP
Chuah
K L
KL
D000328:Adult; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D006099:Granuloma / Q000175:diagnosis*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology; D007818:Laryngeal Diseases / Q000175:diagnosis*; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000821:virology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D009894:Opportunistic Infections / Q000150:complications*; D018235:Smooth Muscle Tumor / Q000175:diagnosis* / Q000556:secondary / Q000821:virology; D014057:Tomography, X-Ray Computed; D014827:Vocal Cords