PMID- 36636068
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230115
IS  - 2078-6891 (Print)
IS  - 2219-679X (Electronic)
IS  - 2078-6891 (Linking)
VI  - 13
IP  - 6
DP  - 2022 Dec
TI  - Concurrent Epstein Barr virus-associated smooth muscle tumor and myeloid sarcoma 
      of the liver and acute myeloid leukemia in a patient post kidney transplant: a 
      case report and review of the literature.
PG  - 3329-3335
LID - 10.21037/jgo-21-700 [doi]
AB  - BACKGROUND: Epstein Barr virus-associated smooth muscle tumors (EBV-SMT) are rare 
      neoplasms that can occur in immunocompromised individuals. The native or 
      transplanted liver is the most commonly involved site in post transplant 
      patients. Systemic therapies have been utilized in EBV-SMT with modest activity. 
      CASE DESCRIPTION: We describe a 23-year-old female kidney transplant recipient 
      who presented with acute myeloid leukemia (AML) and hepatic myeloid sarcoma (MS). 
      Although it was not recognized initially, her liver biopsy revealing MS at 
      diagnosis was posthumously found to have synchronous EBV-SMT. She underwent 
      anthracycline based induction and achieved a complete remission of her AML by 
      bone marrow biopsy. Due to a persistent hepatic mass, she was given salvage 
      chemotherapy including fludarabine, etoposide, cytarabine, decitabine, and 
      venetoclax for presumed refractory MS. Re-biopsy of the liver revealed the 
      absence of MS and presence of EBV-SMT, which subsequently grew rapidly and 
      precluded her from a liver tumor resection. The patient underwent sirolimus 
      mammalian target of rapamycin (mTOR) therapy with palliative intent, but the 
      patient's EBV-SMT progressed shortly after. At time of autopsy, the patient 
      remained in complete remission from AML/MS, but was found to have multifocal 
      progressive metastatic EBV-SMT. CONCLUSIONS: To our knowledge this is the first 
      reported case of synchronous AML/MS and post transplant hepatic EBV-SMT that 
      underwent treatment for AML/MS. Our report suggests that the chemotherapeutic 
      agents utilized for AML/MS may have poor efficacy against EBV-SMT.
CI  - 2022 Journal of Gastrointestinal Oncology. All rights reserved.
FAU - Wang, Victor
AU  - Wang V
AD  - Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, 
      USA.
FAU - Perre, Kimrey Van
AU  - Perre KV
AD  - Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, 
      USA.
FAU - Pu, Lu
AU  - Pu L
AD  - Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, 
      USA.
FAU - Liu, Yan
AU  - Liu Y
AD  - Department of Pathology and Human Anatomy, Loma Linda University Medical Center, 
      Loma Linda, CA, USA.
FAU - Wang, Jun
AU  - Wang J
AD  - Department of Pathology and Human Anatomy, Loma Linda University Medical Center, 
      Loma Linda, CA, USA.
FAU - Choo, Evelyn
AU  - Choo E
AD  - Department of Pathology and Human Anatomy, Loma Linda University Medical Center, 
      Loma Linda, CA, USA.
FAU - Moyers, Justin
AU  - Moyers J
AD  - Division of Medical Oncology and Hematology, Loma Linda University Medical 
      Center, Loma Linda, CA, USA.
FAU - Cao, Huynh
AU  - Cao H
AD  - Division of Medical Oncology and Hematology, Loma Linda University Medical 
      Center, Loma Linda, CA, USA.
FAU - Lau, Eric
AU  - Lau E
AD  - Division of Medical Oncology and Hematology, Loma Linda University Medical 
      Center, Loma Linda, CA, USA.
LA  - eng
PT  - Case Reports
PL  - China
TA  - J Gastrointest Oncol
JT  - Journal of gastrointestinal oncology
JID - 101557751
PMC - PMC9830336
OTO - NOTNLM
OT  - EBV
OT  - EBV smooth muscle tumor
OT  - Epstein Barr virus
OT  - Epstein Barr virus-associated smooth muscle tumors (EBV-SMT)
OT  - case report
OT  - post transplant smooth muscle tumor
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jgo.amegroups.com/article/view/10.21037/jgo-21-700/coif). HC receives 
      honoraria from BMS and Pfizer for Advisory Board Meeting and receives research 
      grant from NIH NCI Diversity Supplement Grant and the Bristol Myers Squibb 
      Foundation for the Robert A. Winn Diversity in Clinical Trials Award Program. The 
      other authors have no conflicts of interest to declare.
EDAT- 2023/01/14 06:00
MHDA- 2023/01/14 06:01
PMCR- 2022/12/01
CRDT- 2023/01/13 01:54
PHST- 2022/04/11 00:00 [received]
PHST- 2022/09/13 00:00 [accepted]
PHST- 2023/01/13 01:54 [entrez]
PHST- 2023/01/14 06:00 [pubmed]
PHST- 2023/01/14 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - jgo-13-06-3329 [pii]
AID - 10.21037/jgo-21-700 [doi]
PST - ppublish
SO  - J Gastrointest Oncol. 2022 Dec;13(6):3329-3335. doi: 10.21037/jgo-21-700.