Hepatic Epstein-Barr Virus-Associated Smooth Muscle Tumor in a Young Woman With Congenital HIV

Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare condition involving smooth muscle tumors in various organs, often in the context of immunodeficiency. Hepatic EBV-SMT usually presents with non-specific symptoms such as abdominal pain and weight loss. We present a case of a 25-year-old woman who presented with multiple liver masses in the setting of congenital human immunodeficiency virus (HIV). Initially, those lesions were suspected to represent metastatic tumors, but the biopsy showed smooth muscle proliferation suggestive of a smooth muscle tumor. Diagnosis of EBV-SMT was confirmed through in situ hybridization for EBV RNA. This case underscores the diagnostic challenges and pathogenesis of EBV-SMT.