Heck's disease occurring after Epstein-Barr virus-associated smooth muscle tumors in an immunosuppressed child
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Updated: Nov 27, 2025

Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
Published on: September 7, 2022
Natasha Arbelo-Ramos1, Katelyn Anderson2, Avni Joshi3
1Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
Abstract:
A 10-year-old Guatemalan girl with past medical history of Epstein-Barr virus-associated smooth muscle tumors (EBV-SMT) and combined immunodeficiency presented for evaluation of painful intraoral lesions. On examination, she was noted to have multiple, white to flesh-colored, soft, flat-topped papules, and plaques on the buccal and labial mucosa. Human papillomavirus type 13 was detected on PCR with PGMY primers of previously biopsied buccal tissue, confirming a diagnosis of Heck's disease (multifocal epithelial hyperplasia). We present an immunosuppressed, pediatric patient with two rare, virus-associated neoplastic disorders that have not been previously reported to occur in the same individual.
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