Sir,I thank the author for the interest shown in our published article and appreciate the new information reported.[1]In fact, the number of reported cases of smooth muscle tumor (SMT) arising in the setting of human immunodeficiency virus (HIV) infection has been increasing for the last three decades. Coinfection with Epstein-Barr virus (EBV) appears to be a necessary cofactor for the development of these tumors.[23] These EBV-related SMT also were reported in posttransplant immunosuppressed patients and individuals with autoimmune disease or iatrogenic immunosuppression.[4] None of these conditions, including HIV infection, was present in the patient of our case report. Detection of EBV was performed in the tumor tissue with negative results.Although EBV-SMT affects especially patients who are young, severely immunosuppressed and have multifocal tumors, it is true that EBV-SMT should be included in the differential diagnosis of any SMT occurring in uncommon sites (e.g., conjunctiva).[2] These tumors appear to have a more favorable prognosis than conventional leiomyosarcoma.
Authors: Tania Lopez Montes; Maria Varela Agra; Mario San Martin Alonso; Alberto Ollero Lorenzo Journal: Indian J Ophthalmol Date: 2017-05 Impact factor: 1.848