Prognostic Differences: Epstein-Barr Virus-Associated Primary Leiomyosarcoma of the Spine Versus Spinal Leiomyosarcoma Metastases

World Neurosurg. 2017 Mar:99:484-490. doi: 10.1016/j.wneu.2016.12.035. Epub 2016 Dec 21.

Abstract

Objective: The authors studied 6 cases of osseous leiomyosarcoma of the spine. Two of these cases were of immunocompromised human immunodeficiency virus (HIV)-positive patients with Epstein-Barr virus (EBV)-associated primary vertebral leiomyosarcomas. The remaining 4 cases were of patients with leiomyosarcoma metastases to the spine.

Methods: Each patient underwent surgical resection of their vertebral mass; however, the patients with the EBV-associated tumors had the best postoperative prognosis.

Results: The HIV-positive patients have had no further local recurrence, while the other 4 patients had rapid local recurrences requiring multiple surgical interventions. Furthermore, the patients living with HIV have lived longer with fewer leiomyosarcoma-related health complications.

Conclusions: These findings suggest that EBV-associated vertebral leiomyosarcoma is of a less aggressive variety than metastatic leiomyosarcoma of the spine.

Keywords: AIDS; Metastatic leiomyosarcoma; Spinal leiomyosarcoma; Spinal metastasis.

Publication types

  • Case Reports

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Docetaxel
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / immunology
  • Female
  • Gemcitabine
  • Herpesvirus 4, Human
  • Humans
  • Immunocompromised Host
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / secondary
  • Leiomyosarcoma / therapy*
  • Leiomyosarcoma / virology
  • Male
  • Mediastinal Neoplasms / complications
  • Mediastinal Neoplasms / pathology
  • Mediastinal Neoplasms / therapy*
  • Mediastinal Neoplasms / virology
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Retroperitoneal Neoplasms / complications
  • Retroperitoneal Neoplasms / pathology
  • Retroperitoneal Neoplasms / therapy*
  • Retroperitoneal Neoplasms / virology
  • Spinal Neoplasms / pathology
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / therapy*
  • Spinal Neoplasms / virology
  • Taxoids / administration & dosage

Substances

  • Taxoids
  • Deoxycytidine
  • Docetaxel
  • Gemcitabine