Neuroradiology
October 5, 2026 · via Europe PMC
Multifocal intracranial epstein-barr virus-associated smooth muscle tumors in an HIV-positive patient: incidental discovery and treatment with staged gamma knife radiosurgery.
Sutanto R, Muljadi R, Hakim AHW, Octavius GS
AI summary — for doctors, generated from the abstract only
A rare case of multiple intracranial Epstein-Barr virus-associated smooth muscle tumors in an HIV-positive patient, initially mistaken for meningioma, was managed successfully with staged Gamma Knife radiosurgery after partial resection confirmed the diagnosis.
What was studied
Case report of a 36-year-old HIV-positive man with incidentally discovered multifocal intracranial EBV-associated smooth muscle tumors (EBV-SMT), describing diagnostic work-up, partial surgical resection, and staged Gamma Knife radiosurgery treatment with 7-month follow-up.
Key findings
- Imaging initially favored multifocal meningioma; subtotal resection and EBER positivity confirmed EBV-SMT, a rare diagnosis with exceptionally uncommon CNS involvement.
- All three lesions were treated with two-stage Gamma Knife radiosurgery using margin doses of 12 Gy and 14 Gy.
- At 7-month follow-up, lesions showed relative size stability and non-enhancing changes consistent with treatment effect, without clinically apparent acute toxicity.
Clinical relevance
Highlights the diagnostic overlap between intracranial EBV-SMT and meningioma in immunocompromised patients and documents a feasible staged radiosurgical treatment approach for multifocal disease.
Who should care
Limitations
Single case report with relatively short follow-up (7 months), so long-term tumor control and radiosurgery durability remain unknown.
In immunocompromised patients, a 'meningioma-like' brain mass may actually be a rare EBV-driven tumor requiring a different treatment approach.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
INTRODUCTION
Epstein-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.
CONCLUSION
This case highlights the diagnostic overlap between intracranial EBV-SMT and meningioma and provides detailed documentation of staged radiosurgical treatment in multifocal disease.
DOI
10.1007/s00234-026-04212-4
PMID
42832032
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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