Epstein-Barr Virus–Associated Smooth Muscle Tumor of the Spine After Bone Marrow Transplant: Case Report and Review of Literature

Epstein-Barr virus–associated smooth muscle tumors (SMTs) are rare neoplasms that have been found to develop in immunocompromised patients. Three distinct groups of affected patients have been described: (1) human immunodeficiency virus–infected patients, (2) post-transplant patients, and (3) patients with congenital immunodeficiency. The tumors can develop anywhere in the body, with 17 reported cases occurring in the spinal canal, all in patients with human immunodeficiency virus infection. We report the first case of Epstein-Barr virus–associated SMT affecting the spinal canal in a post–bone marrow transplant adult patient. Interestingly, unlike other reported cases, the patient described here had not been receiving immunosuppressive therapy in the 2 years prior to diagnosis of the tumor. Despite the growing number of case reports, this diagnosis presents a challenge, as the pathophysiology and optimal treatment regimens are not well understood. Results of a literature review of Epstein-Barr virus–associated SMT of the spine as well as a discussion of the presentation, management, and prognosis of this condition is presented here.