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This case report aims to discuss a rare smooth muscle tumor associated with Epstein-Barr virus in an HIV patient.

February 7, 2026Open Access

Epstein-Barr virus (EBV)-associated smooth muscle tumor of the central nervous system in an HIV patient: diagnostic and therapeutic challenges

IMImad MajeedUniversity of Louisville KHKenneth Schott HannanUniversity of Louisville Hospital ABAeron BuckleyUniversity of Louisville

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This case report aims to discuss a rare smooth muscle tumor associated with Epstein-Barr virus in an HIV patient.
Describes a case of a 39-year-old HIV-positive female with symptoms including headache and seizures.
Utilized Magnetic resonance imaging (MRI) to reveal multiple brain masses.
Conducted a diagnostic cerebral angiogram followed by surgical intervention.
The patient initially showed improvement post-surgery but later succumbed to cardiac arrest and aspiration pneumonia.
Highlights the importance of monitoring CD4 counts and early detection of HIV in managing EBV complications.

Resumen

Epstein-Barr virus (EBV)-associated smooth muscle tumor (EBV-SMT) is a rare spindle cell tumor found in immunocompromised patients with HIV. This case report presents a patient with HIV-positive Epstein-Barr virus (EBV)-associated smooth muscle tumor (EBV-SMT) involving the brain and spine—a 39-year-old Hispanic female with HIV presented with severe headache, neck pain, and seizure-like activity. Magnetic resonance imaging (MRI) revealed multiple brain masses, prompting a diagnostic cerebral angiogram and subsequent surgery to remove them. Despite initial improvement, the patient later succumbed to aspiration pneumonia and cardiac arrest. Epstein-Barr virus (EBV)-associated smooth muscle rare tumors (EBV-SMTs) in HIV patients with low CD4 counts require clinical suspicion and Epstein-Barr virus (EBV) involvement in brain tumor diagnosis. Early HIV detection, CD4 monitoring, and antiretroviral therapy (ART) management can decrease the risk of these malignancies.

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