An unusual hypertrophic genital mass lesion—A diagnostic and treatment dilemma

Vulvar pseudoepitheliomatous hyperplasia associated with herpes simplex virus type II mimicking cancer in an immunocompromised patient

“…Our patient had a very low CD4 count at diagnosis (13 cells/uL) which was raised to more than 200 cells/uL with HAART. Although median time interval from initiating HAART to IRIS from previous reports was approximately 3–5 months (range, 2–12), a few cases occurred even prior to HAART or as late as several years . This was also observed in our patient who developed IRIS 2 years after HAART.…”

“…Recurrent cervical cancer or a new human papilloma virus‐related vulvar cancer was the provisional diagnosis in our patient. Differential diagnoses of verrucous growth in a HIV infected individual are squamous cell carcinoma and lesions caused by opportunistic infection such as condylomata acuminata, condylomata lata, varicella zoster or CMV . An oncologist should keep these differential diagnoses in mind in order not to treat any mass lesions in an immunocompromised patient as cancer until proven pathologically .…”

“…An oncologist should keep these differential diagnoses in mind in order not to treat any mass lesions in an immunocompromised patient as cancer until proven pathologically . Laboratory tests to detect virus causing PEH are helpful . Cytology, histopathology and immunohistochemistry are more commonly used, while immunofluorescence, enzyme immunoassays or polymerase chain reaction are not generally performed unless the morphologic changes are subtle or the tissue obtained is small .…”

HIV-associated Hypertrophic Herpes Simplex Genitalis With Concomitant Early Invasive Squamous Cell Carcinoma Mimicking Advanced Genital Cancer

“…However, in the last 2 decades, several cases have been reported in which HSV infection in HIV-1positive individuals presented an unusual nodular gross appearance (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). This peculiar clinical presentation has been referred to as hypertrophic herpes simplex (4,6,10,16).…”

“…This peculiar clinical presentation has been referred to as hypertrophic herpes simplex (4,6,10,16). Most of the cases of hypertrophic herpes simplex described in the literature occurred in the anogenital area and have been referred to as hypertrophic herpes simplex genitalis (HHSG) (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)14,16). However, rare cases of hypertrophic herpes simplex have also been reported in the tongue (7,13), on the hands (15), and in the endobronchial tube (17).…”