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

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.