Cerebral syphilitic gumma

• Cerebral syphilitic gumma misdiagnosed as brain abscess: A case report
• Gummatous Neurosyphilis With Transient Worsening of Neurological Symptoms After Treatment Initiation
• Cerebral syphilitic Gumma in the modern era: a report of an unusual case and brief review of recent published reports
• Cerebral syphilitic gumma mimicking a brain tumor that enlarged temporarily after commencing antibiotic treatment
• Meningovascular Syphilis Presenting as a Brain Mass in an Immunocompetent Male
• A clinical suspected case of cerebral syphilitic gumma showing spontaneous regression
• Syphilitic Gummata in the Central Nervous System: A Narrative Review and Case Report about a Noteworthy Clinical Manifestation
• Cerebral syphilitic gumma presenting with intracranial gumma and pathologic vertebrae fractures

Cerebral syphilitic gumma is a relatively rare clinical disease. Its clinical manifestations are non-specific, and the imaging manifestations are similar to other intracranial occupying lesions, often misdiagnosed as tumors or abscesses.

Cerebral syphilitic gumma, first described by Botalli in 1563, is a rare manifestation, typically of tertiary syphilis.

Syphilitic gumma involvement of the central nervous system is extremely rare and frequently misdiagnosed.

Cerebral gummas typically arise from the dura and pia mater over the cerebral convexity or at the base of the brain and produce symptoms similar to those of other intracranial tumors.

There are few reports on this disease in the relevant literature. To our knowledge, we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases.

Case summary: We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics. The clinical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported. Clinical manifestations, classifications, and diagnostic points were retrospectively analyzed. The patient was admitted to the hospital with fever and limb weakness. Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum Treponema pallidum gelatin agglutination test. The patient was misdiagnosed as having a brain abscess and underwent a craniotomy. A postoperative pathological diagnosis of syphilis gumma was made. The patient improved and was discharged after penicillin anti-syphilis treatment. Follow-up recovery was satisfactory.

Conclusion: Cerebral syphilitic gumma is rare in clinical practice, and it is often misdiagnosed and missed. Clinical diagnosis should be considered in combination with multiple examinations ¹⁾

Xia et al., report a patient of a cerebral syphilitic gumma resembling a malignant brain tumor in a 62-year-old male. He was first suspected of a malignant brain tumor, but the pathological diagnosis was cerebral syphilitic gumma. This patient with unusual findings illustrates the clinical manifestations, imaging, and therapeutic aspects of cerebral syphilitic gumma ²⁾.

A 59-year-old woman presenting dysarthria showed a mass on her brain computed tomography. She was first suspected of brain tumor, but histological results from surgical resection revealed cerebral gumma due to neurosyphilis. After operation, she presented fever and rash with an infiltration on a chest X-ray. Histological assessment of skin was consistent with syphilis. Fluorescent treponemal antibody absorbed test IgG in cerebrospinal fluid was positive. She was successfully treated with ceftriaxone for 14 days ³⁾.