Aggressive Tongue Root Epstein-Barr Virus–Positive Mucocutaneous Ulcer Treated With Rituximab Alone

Tsutsumi, Minako; Yoshimura, Takuro; Tatsumi, N; Nakaya, Yoshihiro; Fuseya, Hoyuri; Horiuchi, Mirei; Yoshida, Masahiro; Hayashi, Yoshiki; Nakao, Takafumi; Inoue, Takeshi; Yamane, Takahisa

doi:10.1016/j.clml.2019.12.020

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…Administering the monoclonal anti-CD20 antibody rituximab in weekly dosages of 375 mg/m 3 offered an additional therapeutic benefit in several reports [3,4,7,27,37,40,41]. A surgical excision of localised ulcers was mainly performed to exclude a carcinoma or another malignancy [7,17,42] or was necessary to reconstruct tissue defects after regression [15].…”

Section: Resultsmentioning

confidence: 99%

Co-Occurrence of EBV-Positive Mucocutaneous Ulcer (EBV-MCU) and CLL/SLL in the Head and Neck Region

Bott

Oschlies²,

Radeloff

et al. 2022

Current Oncology

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EBV-positive mucocutaneous ulcer (EBV-MCU) was classified as a rare new entity of the lymphoproliferative B-cell diseases by the WHO in 2017 and must be distinguished from head and neck squamous cell carcinoma by early biopsy. The aim of the study is to raise awareness of the disease and to give a review of the current literature and a recommendation for EBV-MCU management. All EBV-MCU cases of the head and neck region published so far were included. We also report a case of a pharyngeal EBV-MCU in an 89-year-old patient who was immunosuppressed by chronic lymphatic leukaemia/small lymphocytic lymphoma (CLL/SLL). In contrast to all previously described cases, histopathology showed a co-infiltration of EBV-MCU and CLL/SLL. A total of 181 cases were identified on PubMed and summarised. EBV-MCU was predominantly caused by immunosuppressive drug therapy. Complete remission could be achieved in 68% of cases and was mainly attributed to a reduction of the immunosuppressive therapy alone (72%). However, some severe cases require more aggressive treatment. Regarding the various histopathologic similarities to other lymphoproliferative disorders, the diagnosis of EBV-MCU can be misleading, with a great impact on patient care and treatment. This diagnosis must be made with caution and requires a combination of clinical, morphological and immunophenotypic features.

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