Presenter
Assem S. Alrumeh
Authors
Assem S. Alrumeh1,2, Phedias Diamandis1,2, Andrew F. Gao1,2
1Dept. of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
2Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
Conflict of Interest
I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose.
Clinical Summary
A 72-year-old woman presented with back pain and was found to have a lytic lesion of the T7 vertebral body.
Recently, she was diagnosed with a hepatic leiomyosarcoma at an outside hospital after having had progressive abdominal pain, unintentional weight loss, and decreased appetite. Her other past medical history included hypertension, hypercholesterolemia, type 2 diabetes mellitus, and remote renal transplant.
CT of the spine showed a lytic lesion in the posterior T7 vertebral body and right pedicle with encroachment of the spinal canal. Prior MRI of the abdomen revealed a well-defined 4.5 x 4.0 cm mass in the liver along with an ovoid lesion adjacent to the left obturator externus muscle.
A T7 laminectomy was performed for tumour excision.
Discussion points
- Differential diagnosis?
- Additional workup?
- Pathogenesis?
Reveal Diagnosis
Epstein-Barr virus-associated smooth muscle tumour (EBV-SMT)
Additional relevant investigations and comment.
Immunohistochemistry stains: SMA, desmin, Caldesmon, Calponin, desmin and EBER
References (optional)
Dekate, J. & Chetty, R. Epstein-Barr VirusAssociated Smooth Muscle Tumor. Arch Pathol Lab Med 140, 718722 (2016).
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