title: EBV-associated hepatic smooth muscle tumor of uncertain biologic behavior after heart transplantation in a pediatric patient: case report.
abstract: Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare neoplasm recognized in immunocompromised patients. There are less than 30 cases of EBV-SMT reported in pediatric population following solid organ transplantation. Herein, we report a case of an 8-year-old female who was incidentally noted to have multiple lesions in the liver 8 years after heart transplantation. The tumor was composed of a cellular proliferation of spindle-shaped cells with low mitotic activity. The diagnosis of EBV-SMT was confirmed byin situhybridization for EBV-encoded small RNA (EBER) transcripts. Multiple additional lesions were detected by whole body positron emission tomography-computed tomography (PET-CT) scan 4 months after the initial finding of the hepatic lesions. Immunosuppression was switched to a mechanistic target of rapamycin (mTOR) inhibitor. We conclude that EBV-SMT should be included in the differential diagnoses in post-transplantation patients and further investigations should be performed to evaluate additional lesions.
authors.affiliation: Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Suneetha
authors.initials: S
authors.lastname: Chintalapati
authors.affiliation: Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Dietz
authors.affiliation: Department of Internal Medicine, Methodist Hospital, Brooklyn, NY, USA.
authors.forename: Adnan S
authors.initials: AS
authors.lastname: Raza
authors.affiliation: Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Anwar Sultana
authors.initials: AS
authors.lastname: Raza
keywords: Epstein-Barr virus (EBV); heart transplantation; pediatric; post transplantation; smooth muscle tumor (SMT)