Background. Epstein-Barr virus (EBV)-related smooth muscle
neoplasms (SMNs) have been associated with immune dysregulation, most notably in patients who have undergone solid
organ transplantation or in patients with HIV/
AIDS. Objective. to report our experience with EBV-related
neoplasms as well as describing the first EBV-related SMN in the setting of administration of
glucocorticoids and the
tumor necrosis factor inhibitor etanercept. Design. We have case reports, of minimum 3-year follow-up, 2002-2005. Setting. It was held in an academic and tertiary referral
cancer center. Patients. Patients are with dysregulated immunity after solid
organ transplantation, HIV/
AIDS, or with
psoriasis after treatment with
etanercept. Interventions. There were discontinuation of
etanercept, right hepatic trisegmentectomy, and
chemotherapy. Measurements. We use survival as a measurement here. Results. Patients who were able to withstand reduction in immunosuppression survived. Surgical resection or
chemotherapy was successful in delaying progression of disease. Limitations. There was a relatively short follow-up for these slow-growing
neoplasms. Conclusion. EBV-related SMNs have variable aggressiveness. While
chemotherapy may slow
disease progression, resection and improving the host immune status provide the best opportunity for primary
tumor control.