Background: Multiple viruses have been associated with carcinogenesis in solid-organ transplant patients. Although Epstein-Barr virus (EBV) has been associated with lymphomas in immunocompromised patients, an association with smooth muscle tumors recently has been described.
Case: An EBV immunoglobulin G-positive woman underwent bilateral lung transplant for sarcoidosis. She was placed on immunosuppression and prophylaxis for opportunistic infections. She presented 5 months later with an EBV-positive uterine leiomyosarcoma. Postoperative therapy included a decrease in immunosuppression and antiviral therapy. Recurrence was noted after 1 year; the patient developed sepsis while undergoing chemotherapy and declined further therapy.
Conclusion: Epstein-Barr virus-associated leiomyosarcoma can occur in the uterus in immunosuppressed patients.