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Pseudoepitheliomatous Hyperplasia Mimicking Vulvar Cancer in a Patient With AIDS

Frimer, Marina MD1; Chudnoff, Scott MD1; Hebert, Tiffany MD2; Shahabi, Shohreh MD1

Journal of Lower Genital Tract Disease: January 2011 - Volume 15 - Issue 1 - p 66-68
doi: 10.1097/LGT.0b013e3181f0b8f5
Case Reports

Background. Pseudoepitheliomatous hyperplasia (PEH) clinically and histologically mimics squamous cell carcinoma (SCC), specifically in patients with HIV and AIDS.

Case. A 51-year-old G3P2 with AIDS and history of vulvar cancer presented with large bilateral exophytic lesions on the vulva, grossly appearing neoplastic. Initial biopsies of the lesions were interpreted as vulvar SCC. After resolution with empiric treatment with acyclovir for possible herpes simplex virus type 2 outbreak, additional slides were reviewed, and cells with viral inclusions were identified, making the final diagnosis PEH in association with herpes simplex virus type 2 infection.

Conclusions. Although PEH is infrequently encountered, PEH should be considered in the differential diagnosis of vulvar lesions. A multidisciplinary approach including the gynecologist, pathologist, and infectious disease specialists can optimize patient outcome.

The diagnosis of pseudoepitheliomatous hyperplasia should be considered in immunocompromised patients with atypical presentation of vulvar squamous cell carcinoma.

1Division of Gynecologic Oncology, Departments of Obstetrics and Gynecology and Women's Health and 2Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY

Reprint requests to: Shohreh S. Shahabi, MD, Danbury Hospital, Department of Obstetrics and Gynecology, 24 Hospital Ave, Danbury, CT 06810. E-mail:

The authors have no potential conflicts of interest to disclose.

©2011The American Society for Colposcopy and Cervical Pathology