title: Epstein-Barr virus-associated leiomyosarcoma with cutaneous involvement in an African child with human immunodeficiency virus: a case report and review of the literature.
abstract: Epstein-Barr virus (EBV)-associated smooth muscle tumors (SMTs) are infrequently encountered lesions restricted to immunocompromised patients. However, they represent the second most common tumor in children with human immunodeficiency virus (HIV) infection. We report a case of a progressively enlarging abdominal mass with cutaneous involvement in an HIV-infected, 4-year-old African girl in Malawi with clinical acquired immunodeficiency syndrome on highly active antiretroviral therapy. Analysis of an excisional specimen revealed a well-differentiated leiomyosarcoma and subsequent studies revealed diffuse nuclear positivity for Epstein-Barr virus early RNAs in lesional cells. We present a report of this case and provide a summary of the literature regarding SMTs in pediatric HIV-infected patients. In addition, we draw attention to the cutaneous manifestations of SMTs in immunosuppressed populations. We highlight EBV-related SMTs as a potential cutaneous complication of HIV infection in children and immunosuppressed patients populations as a whole.
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Tetzlaff
authors.forename: Carl
authors.initials: C
authors.lastname: Nosek
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Kovarik
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D044383:Black People; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000821:virology; D005260:Female; D006678:HIV / Q000378:metabolism*; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006801:Humans; D007890:Leiomyosarcoma / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000821:virology; D012367:RNA, Viral / Q000378:metabolism; D012878:Skin Neoplasms / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000821:virology
chemical_list: D012367:RNA, Viral