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Case report
Transnasal endoscopic resection of Epstein-Barr virus–associated cavernous sinus tumour
  1. Daiki Yokoyama1,
  2. Kentaro Horiguchi1,
  3. Yoshinori Higuchi1 and
  4. Jun Hashiba2
  1. 1Department of neurosurgery, Chiba University Hospital, Chiba, Japan
  2. 2Department of Diagnostic Radiology and Radiation Oncology, Chiba University Hospital, Chiba, Japan
  1. Correspondence to Dr Daiki Yokoyama; wb524wb{at}yahoo.co.jp

Abstract

Epstein-Barr virus–associated smooth muscle tumour (EBV-SMT) is a rare disease occurring in immunosuppressed patients, such as those with AIDS, post-transplantation immunodeficiency and congenital immunodeficiency. Intracranial EBV-SMT after solid organ transplantation has been reported. However, intracranial lesions after bone marrow transplantation are extremely rare. We report the case of a 47-year-old man with a history of acute myeloid leukaemia and bone marrow transplantation. He had symptoms of trigeminal neuralgia, and MRI revealed a left cavernous sinus tumour. He started taking oral gabapentin, but his symptoms did not improve. We performed transnasal endoscopic surgery. Postoperative MRI showed complete removal of the cavernous sinus lesion. Pathological examination showed spindle-shaped cells positive for smooth muscle markers and EBV-encoded small RNA in situ hybridisation. EBV-SMT was pathologically diagnosed. His symptoms improved after surgery. No tumour recurrence was noted on follow-up MRI after 15 months without adjuvant radiation or chemotherapy.

  • neuroimaging
  • neurosurgery
  • cranial nerves
  • head and neck surgery

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Footnotes

  • Contributors DY helped with manuscript writing, editing and design. KH helped in managing and operating the patient. JH conducted diagnostic imaging and radiological review. KH and YH revised the manuscript critically.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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