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Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient.
Pituitary. 2020 Jun; 23(3):253-257.P

Abstract

PURPOSE

Multi-syphilitic gummas in pituitary and cerebellopontine angle (CPA) are extremely rare and easily misdiagnosed especially in patients with antibiotic abuse. We write this paper for clinicians to better understanding of cerebral gumma.

METHODS

We report a patient with syphilitic gummas in pituitary and left CPA. The definite diagnosis is made by histopathology after surgery.

RESULTS

A 49-years-old woman suffered from headaches with tinnitus and hypoacusis in left ear. She was diagnosed with syphilis but untreated. There were no chancre and rashes in the course of disease. Syphilis serological tests were positive. Brain MRI found two masses located in the left CPA and hypophysial fossa. The two masses were removed successively. We found a large number of Treponemapallidum in paraffin-embedded specimens by immunohistochemical staining.

CONCLUSIONS

Syphilitic gummas in pituitary and CPA are similar to benign or malignant brain tumors, easily leading to misdiagnosis. Gumma should be considered in differential diagnosis when a patient has unexplained nervous system symptoms or signs and imaging findings suggest intracranial mass in syphilis seropositive patients.

Authors+Show Affiliations

Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China.Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China.Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China.Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China.Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China.Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China.Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China. neurosurgery@swmu.edu.cn. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People's Republic of China. neurosurgery@swmu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32157493

Citation

Xia, Kaiguo, et al. "Multi-syphilitic Gummas in Pituitary and Cerebellopontine Angle in a Patient." Pituitary, vol. 23, no. 3, 2020, pp. 253-257.
Xia K, Guo Z, Xia X, et al. Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient. Pituitary. 2020;23(3):253-257.
Xia, K., Guo, Z., Xia, X., Ming, Y., Chen, L., Li, X., & Zhong, C. (2020). Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient. Pituitary, 23(3), 253-257. https://doi.org/10.1007/s11102-020-01033-3
Xia K, et al. Multi-syphilitic Gummas in Pituitary and Cerebellopontine Angle in a Patient. Pituitary. 2020;23(3):253-257. PubMed PMID: 32157493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient. AU - Xia,Kaiguo, AU - Guo,Zhangchao, AU - Xia,Xiangguo, AU - Ming,Yang, AU - Chen,Ligang, AU - Li,Xianglong, AU - Zhong,Chuanhong, PY - 2020/3/12/pubmed PY - 2020/3/12/medline PY - 2020/3/12/entrez KW - Misdiagnosis KW - Neurosyphilis KW - Pituitary KW - Syphilitic gumma SP - 253 EP - 257 JF - Pituitary JO - Pituitary VL - 23 IS - 3 N2 - PURPOSE: Multi-syphilitic gummas in pituitary and cerebellopontine angle (CPA) are extremely rare and easily misdiagnosed especially in patients with antibiotic abuse. We write this paper for clinicians to better understanding of cerebral gumma. METHODS: We report a patient with syphilitic gummas in pituitary and left CPA. The definite diagnosis is made by histopathology after surgery. RESULTS: A 49-years-old woman suffered from headaches with tinnitus and hypoacusis in left ear. She was diagnosed with syphilis but untreated. There were no chancre and rashes in the course of disease. Syphilis serological tests were positive. Brain MRI found two masses located in the left CPA and hypophysial fossa. The two masses were removed successively. We found a large number of Treponemapallidum in paraffin-embedded specimens by immunohistochemical staining. CONCLUSIONS: Syphilitic gummas in pituitary and CPA are similar to benign or malignant brain tumors, easily leading to misdiagnosis. Gumma should be considered in differential diagnosis when a patient has unexplained nervous system symptoms or signs and imaging findings suggest intracranial mass in syphilis seropositive patients. SN - 1573-7403 UR - https://www.unboundmedicine.com/medline/citation/32157493/Multi-syphilitic_gummas_in_pituitary_and_cerebellopontine_angle_in_a_patient L2 - https://doi.org/10.1007/s11102-020-01033-3 DB - PRIME DP - Unbound Medicine ER -
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