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Epstein-Barr Virus–Associated Uterine Leiomyosarcoma in an Adult Lung Transplant Patient

Sunde, Jan MD; Chetty-John, Shilpa MD; Shlobin, Oksana A. MD; Boice, Charles R. MD

doi: 10.1097/AOG.0b013e3181c51ed0
Case Reports

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.

Epstein-Barr virus-associated leiomyosarcoma can occur in the uterus in immunosuppressed patients.

From 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.

Corresponding author: Jan Sunde, MD, Madigan Army Medical Center, Department of Obstetrics and Gynecology, Building 9040, Fitzsimmons Drive, Tacoma, WA 98431; e-mail: jesunde@yahoo.com.

© 2010 The American College of Obstetricians and Gynecologists