Tertiary Syphilis Masquerading as Oropharyngeal Cancer

Authors

Caroline R Christmann
Wesley D Figg
Ritodhi Chatterjee
Philip F Lavere
Niraj Mehta

Publication Date

9-1-2022

Journal

Cureus

DOI

10.7759/cureus.28912

PMID

36237821

PMCID

PMC9547047

PubMedCentral® Posted Date

9-7-2022

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

immuno suppresion, oral syphilis, hiv aids, oral mucosal lesions, tertiary syphilis, syphilis

Abstract

Syphilis is re-emerging in the United States. Treponema pallidum, the spirochete bacterium responsible for syphilis, has immunoevasive properties that facilitate pathogenesis and widespread tissue involvement. Host immune status, particularly the presence of HIV/AIDS, can influence the presentation and severity of the disease. Patients co-infected with HIV and syphilis may develop atypical lesions, including those involving the oropharynx. Any immunocompromised patient with tongue lesions and lymphadenopathy is presumed to have a wide differential diagnosis, and tissue sampling with histopathologic analysis is indicated. We present a patient with gumma of the tongue as the initial manifestation of tertiary syphilis.