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Epstein–Barr virus-associated smooth muscle tumour mimicking bilateral vocal process granuloma

Published online by Cambridge University Press:  20 April 2007

E C Gan*
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore
D P C Lau
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore
K L Chuah
Affiliation:
Visiting Consultant, Department of Pathology, Singapore General Hospital, Singapore
*
Address for correspondence: Dr Eng Cern Gan, Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore169608. Fax: 6226 2079 E-mail: ecgan@hotmail.com

Abstract

A case is presented of a 36-year-old Chinese woman with a renal transplant for end-stage renal failure due to Goodpasture's syndrome. She presented with a year's history of throat discomfort and acid regurgitation into her throat. Videolaryngoscopy revealed bilateral vocal process granuloma, presumed to be due to gastroesophageal reflux. A four-week course of high dose omeprazole was prescribed. On follow up a month later, the granulomas had enlarged, and laser excision was undertaken. Histological and immunohistochemical staining was consistent with Epstein–Barr virus-associated smooth muscle tumour. This is believed to be the first reported case in the English literature of such a tumour affecting the vocal process. The aim of this paper is to present the pathogenesis, clinical behaviour and treatment of Epstein–Barr virus-associated smooth muscle tumour, and to review the literature concerning the differential diagnosis of polypoid vocal process lesions.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2007

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