Epstein–Barr Virus–associated Multifocal Leiomyosarcomas Arising in a Cardiac Transplant Recipient: Autopsy Case Report and Review of the Literature

Nur, Samina; Rosenblum, Warren D.; Katta, Uma Devi; Islam, Humayun; Brown, Kathy; Ramaswamy, Gita

doi:10.1016/j.healun.2007.05.022

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 26, Issue 9 , Pages 944-952, September 2007

Epstein–Barr Virus–associated Multifocal Leiomyosarcomas Arising in a Cardiac Transplant Recipient: Autopsy Case Report and Review of the Literature

Samina Nur, MD
- Department of Pathology, Heart Failure and Transplant Service, New York Medical College at Westchester Medical Center, Valhalla, New York
Warren D. Rosenblum, MD
- Department of Medicine, Heart Failure and Transplant Service, New York Medical College at Westchester Medical Center, Valhalla, New York
- Reprint requests: Warren D. Rosenblum, MD, New York Medical College, 19 Bradhurst Avenue, Suite 700, Hawthorne, NY 10532. Telephone: 914-493-2327. Fax: 914-493-1203.
Uma Devi Katta, MD
- Department of Pathology, Heart Failure and Transplant Service, New York Medical College at Westchester Medical Center, Valhalla, New York
Humayun Islam, MD
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York.
Kathy Brown, RN, ANP
- Department of Medicine, Heart Failure and Transplant Service, New York Medical College at Westchester Medical Center, Valhalla, New York
Gita Ramaswamy, MD
- Department of Pathology, Heart Failure and Transplant Service, New York Medical College at Westchester Medical Center, Valhalla, New York

Received 19 January 2006; received in revised form 27 December 2006; accepted 28 May 2007.

Epstein–Barr virus (EBV) associated smooth muscle tumors (SMTs) have been described in patients with acquired immune deficiency syndrome (AIDS) and, more recently, in association with immunosuppression after solid-organ transplantation. We present the autopsy findings of multiple leiomyosarcomas (LMSs) in a 24-year old man who died 18 months after undergoing orthotopic cardiac transplantation for idiopathic cardiomyopathy. The recognition of EBV-driven LMS developing in cardiac transplant recipients in multiple unusual sites is crucial for the management of these patients and should include complete surgical removal anti-viral therapy and modulation of immunosuppression.