Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient

Xia, Kaiguo; Guo, Zhangchao; Xia, Xiangguo; Yang, Ming; Chen, Ligang; Li, Xianglong; Zhong, Chuanhong

doi:10.1007/s11102-020-01033-3

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…16) It is rare that T. pallidum is found in pathologic specimens 7) ; however, T. pallidum has been detected in pathologic specimens of cerebral syphilitic gumma. 17,18) In the present case, spinal syphilitic gumma was histopathologically diagnosed by surgical resection of the symptomatic main lesion at the T6/7 level, and the resolution of another small asymptomatic lesion at the T1 level by postoperative antibiotic treatment with ceftriaxone also contributed to the diagnosis.…”

Section: Discussionmentioning

confidence: 58%

Multiple Spinal Syphilitic Gummas Diagnosed by Postoperative Histopathology and Antibiotic Responsiveness: A Case Report

Niimura

Imai

2021

NMC Case Report Journal

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Neurosyphilis is an infection of the central nervous system by Treponema pallidum. Gummatous neurosyphilis, especially spinal syphilitic gumma, is an exceedingly rare manifestation and may be misdiagnosed as other tumors due to its rarity. A 42-year-old man with a medical history of treatment for syphilis presented with rapidly progressive leg paralysis, leg sensory disturbance, and bladder and rectal disturbance. Spinal MRI demonstrated an intradural extramedullary lesion strongly compressing the spinal cord at the T6/7 level, which was accompanied with dural tail sign and perilesional meningeal thickening at the T6-T8 levels. Small intradural extramedullary lesions were also detected at the T1 and T8 levels. Serological and cerebrospinal fluid examinations for syphilis were both positive. In the treatment of spinal syphilitic gumma, the decompression of the spinal cord by lesionectomy followed by postoperative antibiotic treatment is considered to be an optimal procedure in patients with rapid progression of neurological deterioration. In the present case, the symptomatic main lesion that was compressing the thoracic cord was excised by surgery and analyzed by histopathological examination, and another small asymptomatic lesion was resolved by postoperative antibiotic treatment. Spinal syphilitic gumma was diagnosed using both histopathological findings of the surgically resected lesion and another residual lesion that was resolved by postoperative antibiotic treatment.

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