The therapy of virus-associated epithelial tumors of the face and the lips in organ transplant recipients

Abstract

The risk of developing malignant cutaneous neoplasms is increased after organ transplantation. We report three patients with malignant tumors of the epithelium of the facial skin and the lips after kidney and heart transplantation, respectively. They showed an aggressive course of the disease with more than five synchronous or metachronous basal cell and squamous cell carcinomas. Tissue samples were Epstein-Barr virus (EBV) positive by PCR. Using an in situ hybridization technique EBV-encoded RNA (EBER) was detected in tumor-infiltrating lymphocytes. The aggressive course was not alone controllable by surgical or radiological therapy. The systemic and topical application of cidofovir (Vistide) led to remarkable remissions, to a better confinement and operability of the tumors, and to a cessation of tumor pain. The photodynamic therapy represents another opportunity for managing superficial local recurrences and multiple tumors. In conclusion, the results of these case reports demonstrate that combined antiviral, photodynamic and surgical therapy may be used successfully to treat aggressive cutaneous malignancies in patients after organ transplantation.

Oral health in renal transplant recipients administered cyclosporin A or tacrolimus

“…In the present study no clinically malignant alterations in gingival overgrowth were observed. The incidence of squaomous oral carcinoma and basal cell carcinoma is notably increased after organ transplantation (Hyckel et al , 2003). However, the majority of reports regarding carcinoma associated with immunosuppression are related to the skin.…”

Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

“…In immunocompromised patients, post-transplant lymphoproliferative disease (PTLD) and AIDS-related lymphomas are observed. Several studies further demonstrate that EBV is involved in the development of certain T-cell and Hodgkin's lymphomas [6,7] and some malignant skin neoplasms in transplant recipients [8,9].…”

Local administration of cidofovir for human papilloma virus associated skin lesions in transplant recipients

“…BK virus) and human papilloma virus (HPV) among others [4]. HPV is increasingly seen in organ transplant recipients presenting with warts and condylomata acuminata, as well as neoplastic manifestations which may potentially lead to anal, vulvar, cervical or penile carcinoma [5–7].…”