Herpes simplex virus infection presenting as a piriform sinus mass.
Evidence is accumulating that herpes simplex virus (HSV) infection is implicated in oncogenesis. HSV antigens have been observed in some oral cancers. We present the case of a 62-year-old man who presented with dysphagia, odynophagia, and dysphonia and who was found on computed tomography (CT) to have a mass in his piriform sinus. We suspected a malignancy, but histopathology of biopsy specimens revealed that the mass exhibited the classic signs of the HSV cytopathic effect, including the presence of intranuclear inclusion bodies, ballooning degeneration of epithelial cells, and a ground-glass appearance of some nuclei. The patient responded well to antiviral therapy, and posttherapy CT revealed that the mass had resolved completely. To the best of our knowledge, this is the first report in the literature of a case of HSV infection presenting as a piriform sinus mass.
Brigandi
Laurie A
LA
Department of Otolaryngology-Head and Neck Surgery, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford, USA. lauriebrigandi@yahoo.com
Lanfranchi
Paul V
PV
Scheiner
Edward D
ED
Busch
Scott L
SL
D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003588:Cytopathogenic Effect, Viral; D003680:Deglutition Disorders / Q000209:etiology; D003937:Diagnosis, Differential; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000821:virology; D007830:Larynx / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D018139:Simplexvirus / Q000472:pathogenicity*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology
D000998:Antiviral Agents