1
|
FDG PET/CT Findings of Primary Hepatic Leiomyosarcoma in an Immunocompetent Pediatric Patient. Clin Nucl Med 2017; 42:323-324. [DOI: 10.1097/rlu.0000000000001555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
2
|
Tsai PS, Yeh TC, Shih SL. Primary hepatic leiomyosarcoma in a 5-month-old female infant. Acta Radiol Short Rep 2013; 2:2047981613498722. [PMID: 24349709 PMCID: PMC3863961 DOI: 10.1177/2047981613498722] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 06/28/2013] [Indexed: 12/28/2022] Open
Abstract
Leiomyosarcoma is a malignant mesenchymal neoplasm deriving from the smooth muscle cells. Primary hepatic leiomyosarcoma is very rare. Its onset is always during middle and old age. Herein, we present a case of primary hepatic leiomyosarcoma in a 5-month-old girl who may be the youngest patient reported in the known published English literature.
Collapse
Affiliation(s)
- Pei-Shan Tsai
- Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ting-Chi Yeh
- Division of Pediatric Hematology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shin-Lin Shih
- Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan ; Department of Radiology, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
3
|
Sarcomas other than Kaposi sarcoma occurring in immunodeficiency: interpretations from a systematic literature review. Curr Opin Oncol 2012; 24:537-46. [PMID: 22729152 DOI: 10.1097/cco.0b013e328355e115] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW In immunodeficiency, an increased sarcoma risk is confirmed for Kaposi's sarcoma. Whether rates of other sarcoma subtypes are elevated in the setting of immunodeficiency is not known. We therefore reviewed published case reports on HIV and AIDS patients and organ transplant recipients with sarcomas. For comparison, we assessed sarcomas in the U.S. general population using Surveillance Epidemiology End Results (SEER) data. RECENT FINDINGS A total of 176 non-Kaposi sarcoma were identified, 75 in people with HIV and AIDS and 101 in transplant recipients. Leiomyosarcomas (n = 101) were the most frequently reported sarcomas, followed by angiosarcomas (n = 23) and fibrohistiocytic tumors (n = 17). Leiomyosarcomas were reported with two age peaks, in children and young adults. Epstein-Barr virus (EBV) was detected in the tumor cells in 85 and 88% of leiomyosarcomas in HIV-infected people and transplant recipients, respectively. Angiosarcomas and fibrohistiocytic tumors were most frequently reported in men. Among kidney transplant recipients, 20% of sarcomas arose at the site of an arteriovenous fistula. In comparison, leiomyoscarcomas, angiosarcomas, and fibrohistiocytic tumors comprised 16.9, 3.8, and 18.7% of sarcomas in the U.S. general population. SUMMARY Leiomyosarcoma and angiosarcoma may occur disproportionately in immunodeficiency. Leiomyosarcomas appear causatively linked to EBV, whereas angiosarcomas might be correlated with an arteriovenous fistula. Additional studies are necessary to understand the contribution of immunodeficiency to the cause of these sarcomas.
Collapse
|
4
|
Tetzlaff MT, Nosek C, Kovarik CL. Epstein-Barr virus-associated leiomyosarcoma with cutaneous involvement in an African child with human immunodeficiency virus: a case report and review of the literature. J Cutan Pathol 2011; 38:731-9. [PMID: 21623869 DOI: 10.1111/j.1600-0560.2011.01721.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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.
Collapse
Affiliation(s)
- Michael T Tetzlaff
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | | |
Collapse
|
5
|
Abstract
Among individuals with HIV-infection, coinfection with oncogenic viruses including EBV, HHV-8, and HPV cause significant cancer-related morbidity and mortality. It is clear that these viruses interact with HIV in unique ways that predispose HIV-infected individuals to malignant diseases. In general, treatment directed specifically against these viruses does not appear to change the natural history of the malignant disease, and once the malignancy develops, if their health permits, HIV-infected patients should be treated using similar treatment protocols to HIV-negative patients. However, for the less frequent HIV-related malignancies, such as PEL, or MCD, optimal treatments are still emerging. For certain AIDS-defining malignancies, it is clear that the widespread access to HAART has significantly decreased the incidence, and improved outcomes. However, for other cancers, such as the HPV-related tumors, the role of HAART is much less clear. Further research into prevention and treatment of these oncogenic virally mediated AIDS-related malignancies is necessary.
Collapse
Affiliation(s)
- Anita Arora
- Center for Clinical Studies, Houston, TX, USA
| | | | | |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW Since the introduction of highly active antiretroviral therapy (HAART), the natural history of human immunodeficiency virus (HIV) infection has changed. Early in the acquired immunodeficiency syndrome (AIDS) epidemic, epidemiologic studies showed that HIV-infected patients were at higher risk for developing specific AIDS-defining malignancies. More recent studies linking HIV/AIDS databases to cancer registries have shown that HIV-infected patients are also at higher risk of developing non-AIDS-defining malignancies. We review the most recent data regarding clinical presentation, pathology, and treatment outcomes for these non-AIDS-defining malignancies. RECENT FINDINGS Recent large cohort studies linking HIV/AIDS databases to cancer registries have shown that HIV-infected patients are also at higher risk of developing non-AIDS-defining malignancies. Besides anal cancer and Hodgkin disease, the cohort studies have identified other malignancies that appear to occur at a higher rate in the HIV-infected population as compared with the general population. These malignancies include lung cancer, skin cancer, germ cell tumors, leiomyosarcomas, cancers of the head and neck, conjunctival cancer, multiple myeloma, and leukemias. SUMMARY As the epidemiology of non-AIDS-defining malignancies continues to evolve, it is unclear whether the appropriate treatments and outcomes for these or other malignancies are changed for HIV-infected patients treated with HAART.
Collapse
Affiliation(s)
- Elizabeth Y Chiao
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA
| | | |
Collapse
|
7
|
Abstract
Benign liver tumors are becoming a subject of great interest because increased access to medical care has allowed discovery of many incidental focal lesions. These tumors may be hepatocellular, biliary, or stromal in nature. Several new lesions have been described in recent years causing a need to reassess the pathogenesis and classification of hepatic tumors. Hepatocellular nodules may be neoplastic or a regenerative response to injury. The size and structure of regenerative nodules varies with the distribution and severity of the hepatic injury, leading to a complex classification. Variation in fat content is easily detected on ultrasonography as focal fatty change and focal fatty sparing. Biliary and stromal cells also produce neoplastic or regenerative lesions. Biliary lesions are often cystic in nature. Stromal lesions are varied because of the many nonparenchymal cell types in the liver.
Collapse
Affiliation(s)
- Ian R Wanless
- Department of Pathology, Toronto General Hospital, 200 Elizabeth Street, Room E4-305, Toronto, ON M5G 2C4, Canada.
| |
Collapse
|
8
|
Affiliation(s)
- P Trubowitz
- San Francisco General Hospital, University of California, San Francisco, USA
| | | | | |
Collapse
|
9
|
Jenson HB, Montalvo EA, McClain KL, Ench Y, Heard P, Christy BA, Dewalt-Hagan PJ, Moyer MP. Characterization of natural Epstein-Barr virus infection and replication in smooth muscle cells from a leiomyosarcoma. J Med Virol 1999. [DOI: 10.1002/(sici)1096-9071(199901)57:1<36::aid-jmv6>3.0.co;2-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
10
|
Haller JO. AIDS-RELATED MALIGNANCIES IN PEDIATRICS. Radiol Clin North Am 1997. [DOI: 10.1016/s0033-8389(22)00737-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
11
|
Jenson HB, Leach CT, McClain KL, Joshi VV, Pollock BH, Parmley RT, Chadwick EG, Murphy SB. Benign and malignant smooth muscle tumors containing Epstein-Barr virus in children with AIDS. Leuk Lymphoma 1997; 27:303-14. [PMID: 9402327 DOI: 10.3109/10428199709059684] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Smooth muscle tumors (leiomyosarcomas) are the second most prevalent malignancy of children with the acquired immunodeficiency syndrome (AIDS). We have investigated the tumors, plasma, and peripheral white blood cells of eight children with AIDS with smooth muscle tumors for evidence of tumor association with human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV). Very low levels of HIV were found in the tumors of the AIDS patients, probably resulting from blood-borne carriage of virus. These smooth muscle tumors had very high quantities of EBV in all the tumor cells by in situ hybridization, with an average of 4.5 EBV genomes per cell by quantitative polymerase chain reaction amplification. Increased amounts of EBV were found in the peripheral blood cells of two AIDS patients before the time of tumor diagnosis. EBV clonality studies demonstrated different monoclonal EBV infection of two separate colonic tumors from one patient, and dual or mixed monoclonal EBV infection in another patient. The muscle cells of leiomyomas and leiomyosarcomas of patients with AIDS demonstrated prominent staining with antibodies to the EBV receptor. The uniform distribution and striking amount of EBV in the tumor cells demonstrates that EBV is capable of infecting smooth muscle cells and that these cells support EBV replication. Clonal EBV proliferation suggests that EBV infection occurs at an early stage of tumor development. These findings indicate that EBV has a causal role in the oncogenesis of leiomyosarcomas of patients with AIDS.
Collapse
Affiliation(s)
- H B Jenson
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, USA.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
de Chadarévian JP, Wolk JH, Inniss S, Lischner HW, d'Amore F, Faerber EN, Isaacson GC. A newly recognized cause of wheezing: AIDS-related bronchial leiomyomas. Pediatr Pulmonol 1997; 24:106-10. [PMID: 9292901 DOI: 10.1002/(sici)1099-0496(199708)24:2<106::aid-ppul5>3.0.co;2-m] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We present two human immunodeficiency virus-infected children who developed wheezing and radiological evidence of pulmonary air trapping due to intra- and peribronchial leiomyomas. At autopsy, leiomyomas were also found in their spleens, which to our knowledge, has never been reported. The smooth muscle tumors were strongly positive for the Epstein-Barr virus, as demonstrated by in situ hybridization to Epstein-Barr virus-encoded ribonucleic acid, confirming the findings of recent investigators and linking these tumors to the Epstein-Barr virus.
Collapse
Affiliation(s)
- J P de Chadarévian
- Department of Pathology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania 19134-1095, USA
| | | | | | | | | | | | | |
Collapse
|
13
|
Cordova Z, Nofech-Mozes S, Witzling M, Gorenstein A, Ballin A. Gastrointestinal smooth muscle tumors and iron deficiency anemia in children. MEDICAL AND PEDIATRIC ONCOLOGY 1997; 28:441-3. [PMID: 9143390 DOI: 10.1002/(sici)1096-911x(199706)28:6<441::aid-mpo9>3.0.co;2-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Smooth muscle tumors are rarely seen in the pediatric population. We present a child with smooth muscle tumor of low malignant potential in the ileocecal valve region in whom iron deficiency anemia was the only presenting sign. Abdominal computed tomographic (CT) scan, barium enema, and colonoscopy revealed the mass. Following resection of the tumor the anemia was corrected and the child feels well.
Collapse
Affiliation(s)
- Z Cordova
- Department of Pediatrics, Edith Wolfson Medical Center, Holon, Israel
| | | | | | | | | |
Collapse
|
14
|
Sadahira Y, Moriya T, Shirabe T, Matsuno T, Manabe T. Epstein-Barr virus-associated post-transplant primary smooth muscle tumor of the liver: report of an autopsy case. Pathol Int 1996; 46:601-4. [PMID: 8893230 DOI: 10.1111/j.1440-1827.1996.tb03660.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Epstein-Barr (EB) virus-associated primary smooth muscle tumors have been reported in immunosuppressed young patients with acquired immunodeficiency syndrome (AIDS) and young people who have undergone liver transplantation. An autopsy case of EB virus-associated smooth muscle cell tumor in a 21 year old female who received immunosuppressive therapy following renal transplantation is reported. Multiple tumor nodules were present in the liver, but no primary lesion was found in any other organ. Histologically, the nodules were composed of spindle cells, positive for alpha-smooth muscle actin, which were arranged in fascicles and closely associated with vascular channels, thereby suggesting a vascular smooth muscle cell origin. EB virus infection of the tumor cells was clearly demonstrated by in situ hybridization with an EB virus-encoded RNA 1 (EBER-1) probe. The present case illustrates that EB virus infection may play some role in the development of smooth muscle tumors not only in immunocompromised young patients with liver allografts, but also in those with renal allografts.
Collapse
Affiliation(s)
- Y Sadahira
- Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
| | | | | | | | | |
Collapse
|
15
|
Davidoff AM, Hebra A, Clark BJ, Tomaszewski JE, Montone KT, Ruchelli E, Lau HT. Epstein-Barr virus-associated hepatic smooth muscle neoplasm in a cardiac transplant recipient. Transplantation 1996; 61:515-7. [PMID: 8610372 DOI: 10.1097/00007890-199602150-00036] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Host immunosuppression is increasingly recognized as a significant risk factor for the development of a primary neoplasm. Chronic immunosuppressive therapy, as used in organ transplantation, may perturb the immunosurveillance ability of the host, making the patient more susceptible to virus-associated malignancies. We have taken care of a care of a child who received an orthotopic heart transplant and who then developed both a generalized lymphoproliferative disorder and a leiomyoma of the liver a year later. Epstein-Barr virus DNA was detected in a lymph node initially and the hepatic tumor cells subsequently. The former responded to a reduction in the immunosuppressive medications and the latter responded to surgical resection. This is the first report of a hepatic smooth cell neoplasm occurring following cardiac transplant and the development of two sequential Epstein-Barr virus-associated disorders in an immunosuppressed patient.
Collapse
Affiliation(s)
- A M Davidoff
- Department of Surgery, Children's Hospital of Philadelphia, Pennsylvania, 19104-4399, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
Dunn NL, Massey GV. NEOPLASIA. Immunol Allergy Clin North Am 1995. [DOI: 10.1016/s0889-8561(22)00838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|