Moore Dalal Kimberly, Antonescu Cristina R, Dematteo Ronald P, Maki Robert G
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Sarcoma. 2008;2008:859407. doi: 10.1155/2008/859407. Epub 2008 Nov 30.
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.
背景。爱泼斯坦-巴尔病毒（EBV）相关的平滑肌肿瘤（SMN）与免疫失调有关，最显著的是在接受实体器官移植的患者或患有HIV/AIDS的患者中。目的。报告我们在EBV相关肿瘤方面的经验，并描述在使用糖皮质激素和肿瘤坏死因子抑制剂依那西普的情况下首例EBV相关的SMN。设计。我们有2002年至2005年的病例报告，随访至少3年。地点。在一家学术性三级转诊癌症中心进行。患者。实体器官移植后免疫失调的患者、HIV/AIDS患者或接受依那西普治疗后患有银屑病的患者。干预措施。停用依那西普、右肝三段切除术和化疗。测量指标。我们在此使用生存率作为测量指标。结果。能够耐受免疫抑制降低的患者存活下来。手术切除或化疗成功地延缓了疾病进展。局限性。对于这些生长缓慢的肿瘤，随访时间相对较短。结论。EBV相关的SMN具有不同的侵袭性。虽然化疗可能会减缓疾病进展，但切除肿瘤和改善宿主免疫状态为原发性肿瘤控制提供了最佳机会。
