Cerebral syphilitic gumma masquerading as cerebral metastatic tumors: case report

Neurosurgical Focus
Chuanbo WengTingmiao Wu

Abstract

A 45-year-old man was admitted with severe headache and left-sided weakness, which worsened over 1 week. Brain imaging revealed a small lesion close to the sagittal sinus in the right frontal lobe with severe perilesional edema and showed enhancement on both CT and MRI obtained with contrast. Serological findings were positive for toluidine red unheated serum test (TRUST) positivity and Treponema pallidum particle agglutination assay. The patient was first suspected of having a malignant brain tumor and subsequently received emergency craniotomy. Brain biopsy suggested a diagnosis of syphilitic cerebral gumma; meanwhile the postoperative CSF TRUST titer was positive, and the patient's improvement with high-dose intravenous aqueous crystalline penicillin further supported this etiology. Finally, the lesion on the right frontal lobe had disappeared during the follow-up imaging examination and the myodynamia of the left limbs gradually improved. The authors recommend that diagnostic penicillin treatment should be first implemented. When a patient's history, clinical manifestations, syphilis serology, CSF examination, and other physiological changes indicate a diagnosis of syphilitic cerebral gumma, there is no doubt that surgery s...Continue Reading

References

Apr 16, 1992·The New England Journal of Medicine·E W Hook, C M Marra
Nov 19, 2004·Journal of Neurology, Neurosurgery, and Psychiatry·M Timmermans, J Carr
Oct 7, 2009·Antimicrobial Agents and Chemotherapy·Lola V Stamm
Dec 15, 2010·Current Opinion in Infectious Diseases·Joseph D Tucker, Myron S Cohen
Dec 8, 2015·The American Journal of Cardiology·Francesco DragoAurora Parodi
Jan 2, 2016·International Journal of STD & AIDS·M KingstonAnn Sullivan
Jul 15, 2016·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Y JiangX H Chen
Mar 15, 2018·Frontiers in Neuroscience·Xuefei ShaoBihua Ji

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