VISCERAL MYOGENIC TUMORS - A MANIFESTATION OF HIV-INFECTION IN CHILDREN

We report a primary smooth-muscle tumor of undetermined malignant pote ntial of the liver in a child with acquired immune deficiency syndrome (AIDS). This patient represents the eighth child infected with the hu man immunodeficiency virus who developed a mesenchymal tumor other tha n Kaposi's sarcoma. All these children were younger than 10 years of a ge. These tumors often were histologically or clinically malignant and all but one were smooth-muscle tumors. These tumors arose exclusively in visceral organs, and the hepatobiliary, gastrointestinal, and trac heopulmonary systems were involved. Transmission of the virus occurred both vertically (in six children) and via blood transfusion (in two). Given the rarity of smooth-muscle tumors in uninfected children, the unusual frequency of these tumors suggests that immunosuppression indu ced by the virus permits the unregulated proliferation of a primitive mesenchymal cell disposed to myogeneous differentiation, a situation n ot unlike that observed in the development of AIDS-related Kaposi's sa rcoma in adults.