Oral Medicine

A rare case report of syphilis mimicking an oropharyngeal neoplasm

DOI: https://doi.org/10.25241/stomaeduj.2021.8(1).art.8

Sofia Kalantary1a, Christophe Politis2b* , Wouter De Vos1,3c, Sten Stevens1d, Maarten Van Genechten1,3e,
Herman Jr Vercruysse1,3f, Geert Van Hemelen1g

1ZMACK / Associatie MKA, AZ Monica Antwerp, Belgium
2Department of Maxillofacial Surgery, Hôpital Erasme, Université Libre de Bruxelles – ULB, Brussels, Belgium
3Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Z.M.A.C.K association of Antwerp

aMD, DDS, Maxillofacial Surgery Resident; e-mail: kalantarysofia89@gmail.com;
bMD, DDS, Maxillofacial Surgery Resident; e-mail: christophe.politis@gmail.com; ORCIDiD: https://orcid.org/0000-0002-1076-1327
cMD, DDS, Maxillofacial Surgeon; e-mail: de.vos.w@gmail.com;
dMD, DDS, Maxillofacial Surgeon; e-mail: sten.stevens@gmail.com;
eMD, DDS, Maxillofacial Surgeon; e-mail: maartenvangenechten@telenet.be;
fMD, DDS, Maxillofacial Surgeon; e-mail: juni90@hotmail.com;
gMD, DDS, Maxillofacial Surgeon; e-mail: drvanhemelen@azmonica.be;

 

Abstract

Aim Syphilis is a widely spread, sexually transmitted disease that is often considered archaic, but it has been on the rise in recent years. The oropharyngeal region is an uncommon location for treponema pallidum to present itself. It is even more uncommon when, on a radiological evaluation, it is diagnosed as a neoplasm or squamous cell carcinoma. This case report discusses a rare case of syphilis that mimics an oropharyngeal carcinoma.
Summary The patient presented himself initially with cervical lymphadenopathies and an oropharyngeal lesion. On the MRI scan, the lesion was suspicious for an oropharyngeal squamous cell carcinoma. Multiple negative biopsies (2X) urged the search for an alternative diagnosis. After serologic testing, it became clear the patient was suffering from syphilis. Syphilis is known as the “great pretender” and can present in a non-specific manner.
Key learning points
i) Syphilis is known as the “great pretender”.
ii) Treponema pallidum infections need to be taken into account as a differential diagnosis in patients with an oropharyngeal lesion.
iii) Syphilis is on the rise.
iv) Syphilis has the ability to mimic a malignancy upon clinical presentation.
v) Syphilis has the ability to mimic a malignancy on CT and MRI-imaging.

Keywords

Syphilis; Cervical Lymph Node; Oropharyngeal Ulceration; Carcinoma; Mimicking.

 

 

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