A CASE OF ORAL SYPHILIS DIFFICULT TO DISTINGUISH FROM MALIGNANT TUMOR

Abstract

Syphilis is a sexually transmitted disease caused by treponema pallidum infection. Induration, hard chancre, or indolent regional lymphadenopathy can occur in the infection site as an initial symptom during primary syphilis. In this study, we report a case of differentiation requirement of malignant tumor in an 87-year-old male who visited our institution with the chief complaints of a tumor on the dorsum of his tongue and cervical lymphadenopathy. Conspicuous enlargement of the cervical lymph node was found on CT and MRI examination. After the histopathologic examination and blood test for the purpose of tongue cancer and malignant tumor, a malignant tumor was histopathologically denied; therefore, we diagnosed it as oral syphilis with 185R.U. as a high syphilis RPR （rapid plasma reagin） level. Treatment was provided with oral administration of amoxicillin （AMPC） 1,500mg/day, and six weeks later, the tongue and enlargement of the cervical lymph node were resolved. At the 15th week, we finished treatment because of normalization to a RPR level of 3.9R.U.