A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation
Epstein-Barr virus (EBV) infection might induce not only posttransplantation lymphoproliferative disorder (PTLD) but also leiomyosarcoma. We report a case of EBV-associated leiomyosarcoma concurrently with PTLD after renal transplantation. The patient was a 30-year-old woman who underwent living don...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-07-01
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| Series: | Clinical Medicine Insights: Case Reports |
| Online Access: | https://doi.org/10.1177/1179547619867330 |
| _version_ | 1818146178555969536 |
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| author | Naohiro Aida Taihei Ito Michihiro Maruyama Kenichi Saigo Naotake Akutsu Hiromichi Aoyama Hiroshi Kitamura Takashi Kenmochi |
| author_facet | Naohiro Aida Taihei Ito Michihiro Maruyama Kenichi Saigo Naotake Akutsu Hiromichi Aoyama Hiroshi Kitamura Takashi Kenmochi |
| author_sort | Naohiro Aida |
| collection | DOAJ |
| description | Epstein-Barr virus (EBV) infection might induce not only posttransplantation lymphoproliferative disorder (PTLD) but also leiomyosarcoma. We report a case of EBV-associated leiomyosarcoma concurrently with PTLD after renal transplantation. The patient was a 30-year-old woman who underwent living donor kidney transplantation at 27 years of age. Preoperative EBV viral capsid antibody immunoglobulin M, immunoglobulin G (IgG), and EBV nuclear antigen IgG were negative. Multiple lung and liver tumors were detected 1.5 years after transplantation. She was diagnosed with PTLD after tumor biopsy. Her EBV DNA was 110 copies/mL detected by real-time polymerase chain reaction when PTLD was diagnosed. She received dose reduction of immunosuppressive therapy and several chemotherapies. Because her hepatic lesion was still progressive while pulmonary lesion was reduced, a liver tumor biopsy was performed, but the biopsy specimens were necrotic. A left lateral segmentectomy was performed as a third biopsy for treatment-resistant hepatic lesion 2.5 years after her first PTLD diagnosis. Pathologically, she was diagnosed with EBV-associated leiomyosarcoma. She was treated with sirolimus, but died 7 months after the operation. This is the first case of the coincidence of leiomyosarcoma associated with EBV and PTLD. This case was exceedingly rare; however, we must consider the coincidence of leiomyosarcoma associated with EBV and PTLD when encountering treatment-resistant PTLD. |
| first_indexed | 2024-12-11T12:15:13Z |
| format | Article |
| id | doaj.art-9fe6d2ef52f04908990282c5196c275a |
| institution | Directory Open Access Journal |
| issn | 1179-5476 |
| language | English |
| last_indexed | 2024-12-11T12:15:13Z |
| publishDate | 2019-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Case Reports |
| spelling | doaj.art-9fe6d2ef52f04908990282c5196c275a2022-12-22T01:07:41ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762019-07-011210.1177/1179547619867330A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal TransplantationNaohiro Aida0Taihei Ito1Michihiro Maruyama2Kenichi Saigo3Naotake Akutsu4Hiromichi Aoyama5Hiroshi Kitamura6Takashi Kenmochi7Department of Transplantation and Regenerative Medicine, Graduate School of Medicine, Fujita Health University, Toyoake, JapanDepartment of Transplantation and Regenerative Medicine, Graduate School of Medicine, Fujita Health University, Toyoake, JapanDepartment of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Surgery, National Hospital Organization Chiba-East Hospital, Chiba, JapanDepartment of Surgery, National Hospital Organization Chiba-East Hospital, Chiba, JapanDepartment of Surgery, National Hospital Organization Chiba-East Hospital, Chiba, JapanDepartment of Pathology, National Hospital Organization Chiba-East Hospital, Chiba, JapanDepartment of Transplantation and Regenerative Medicine, Graduate School of Medicine, Fujita Health University, Toyoake, JapanEpstein-Barr virus (EBV) infection might induce not only posttransplantation lymphoproliferative disorder (PTLD) but also leiomyosarcoma. We report a case of EBV-associated leiomyosarcoma concurrently with PTLD after renal transplantation. The patient was a 30-year-old woman who underwent living donor kidney transplantation at 27 years of age. Preoperative EBV viral capsid antibody immunoglobulin M, immunoglobulin G (IgG), and EBV nuclear antigen IgG were negative. Multiple lung and liver tumors were detected 1.5 years after transplantation. She was diagnosed with PTLD after tumor biopsy. Her EBV DNA was 110 copies/mL detected by real-time polymerase chain reaction when PTLD was diagnosed. She received dose reduction of immunosuppressive therapy and several chemotherapies. Because her hepatic lesion was still progressive while pulmonary lesion was reduced, a liver tumor biopsy was performed, but the biopsy specimens were necrotic. A left lateral segmentectomy was performed as a third biopsy for treatment-resistant hepatic lesion 2.5 years after her first PTLD diagnosis. Pathologically, she was diagnosed with EBV-associated leiomyosarcoma. She was treated with sirolimus, but died 7 months after the operation. This is the first case of the coincidence of leiomyosarcoma associated with EBV and PTLD. This case was exceedingly rare; however, we must consider the coincidence of leiomyosarcoma associated with EBV and PTLD when encountering treatment-resistant PTLD.https://doi.org/10.1177/1179547619867330 |
| spellingShingle | Naohiro Aida Taihei Ito Michihiro Maruyama Kenichi Saigo Naotake Akutsu Hiromichi Aoyama Hiroshi Kitamura Takashi Kenmochi A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation Clinical Medicine Insights: Case Reports |
| title | A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation |
| title_full | A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation |
| title_fullStr | A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation |
| title_full_unstemmed | A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation |
| title_short | A Case of Epstein-Barr Virus–Associated Leiomyosarcoma Concurrently With Posttransplant Lymphoproliferative Disorders After Renal Transplantation |
| title_sort | case of epstein barr virus associated leiomyosarcoma concurrently with posttransplant lymphoproliferative disorders after renal transplantation |
| url | https://doi.org/10.1177/1179547619867330 |
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