ArticleNeuroradiology2026
Multifocal intracranial epstein-barr virus-associated smooth muscle tumors in an HIV-positive patient: incidental discovery and treatment with staged gamma knife radiosurgery.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionEpstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare mesenchymal neoplasm occurring predominantly in immunocompromised individuals, with central nervous system involvement exceptionally uncommon. CASE PRESENTATION: A 36-year-old HIV-positive man underwent non-contrast head CT after a road traffic accident, which incidentally revealed multifocal extra-axial intracranial masses. MRI demonstrated avidly enhancing dural-based lesions with hemorrhagic components and venous sinus attachment, initially favoring multifocal meningioma. Subtotal resection of the dominant right parieto-occipital lesion demonstrated a low-grade spindle cell neoplasm with smooth muscle differentiation and diffuse EBER positivity, confirming EBV-SMT. All three lesions subsequently underwent two-stage Gamma Knife radiosurgery, with margin doses of 12 Gy and 14 Gy. Seven-month follow-up demonstrated relative lesion-size stability and central non-enhancing changes suggestive of treatment effect, without clinically apparent acute toxicity.
conclusionThis case highlights the diagnostic overlap between intracranial EBV-SMT and meningioma and provides detailed documentation of staged radiosurgical treatment in multifocal disease.
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