An Unusual Case of Tertiary Syphilis Behaving Like Tongue Squamous Cell Carcinoma

Roberto N. Solis, Brooks Kuhn, D Gregory Farwell

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Syphilis may present with a myriad of oral manifestations in the primary, secondary, and tertiary stages, and may be confused with malignancy. Despite a rise in the incidence of syphilis, tertiary syphilis is exceedingly rare. Tertiary syphilis gummas usually affect the hard palate, while tongue involvement is very rare. A 55-year-old male with extensive smoking and alcohol use was referred for malignancy evaluation with an ulcerative mass creating a tongue cleft, and a positron emission tomography scan suggestive for malignancy. Biopsy results demonstrated no carcinoma but histology demonstrated granulomatous inflammation. Further laboratory results demonstrated elevated rapid plasma reagin titers with Treponema pallidum immunoglobulin G antibodies present. The patient was diagnosed with tertiary syphilis, received appropriate antibiotic therapy, and had healing of the tongue with a persistent cleft. Syphilis may mimic many disease processes. As such, it is important to include this disease in the differential of an unusual tongue lesion. An oral lesion may be the first sign of infection.

Original languageEnglish (US)
JournalJournal of Investigative Medicine High Impact Case Reports
StatePublished - Dec 1 2018


  • granulomatous inflammation
  • oral manifestations
  • syphilis
  • tertiary syphilis
  • tongue

ASJC Scopus subject areas

  • Epidemiology
  • Safety, Risk, Reliability and Quality
  • Safety Research


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