Oral Herpes Simplex Virus Mimicking Tongue Squamous cell Carcinoma in Von Hippel-Lindau Patient: A Case Image

Head Neck Pathol. 2025 Jan 7;19(1):4. doi: 10.1007/s12105-024-01721-7.

Abstract

We present the case of a 51-year-old man with Von Hippel-Lindau disease and a history of renal transplantation who developed a persistent, painful tongue lesion with episodes of significant swelling. Given his history of prolonged immunosuppression and elevated cancer risk, oral squamous cell carcinoma was a major concern. However, histopathological evaluation confirmed recrudescent herpes simplex virus (HSV) infection rather than malignancy. The lesion fully resolved with antiviral therapy. This case is notable for its presentation mimicking malignancy in a high-risk patient and highlights the importance of considering infectious etiologies in immunosuppressed individuals. It underscores the need for thorough histopathologic evaluation to prevent misdiagnosis and ensure appropriate treatment, especially in patients at increased risk for both infection and cancer.

Keywords: Herpes simplex virus (HSV); Immunosuppression; Oral squamous cell carcinoma; Tongue lesion; Transplant-associated malignancy; Ulcerated mass.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology
  • Diagnosis, Differential
  • Herpes Simplex / complications
  • Herpes Simplex / diagnosis
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Simplexvirus
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / virology
  • Tongue Neoplasms* / diagnosis
  • Tongue Neoplasms* / pathology
  • Tongue Neoplasms* / virology
  • von Hippel-Lindau Disease* / complications
  • von Hippel-Lindau Disease* / diagnosis