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Case Report

A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report

  • Authors:
    • Yujie Ji
    • Shelin Liu
    • Yunwei Wang
    • Youcai Zhao
    • Zheng Cai
    • Bing Li
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, Jiangnan University Medical Center, Jiangnan University, Wuxi, Jiangsu 214000, P.R. China, Department of Bioinformatics, School of Science, Xi'an Jiaotong‑Liverpool University, Suzhou, Jiangsu 215000, P.R. China, Department of Pathology, Nanjing No. 1 People's Hospital, Nanjing, Jiangsu 210000, P.R. China
  • Article Number: 119
    |
    Published online on: February 26, 2026
       https://doi.org/10.3892/etm.2026.13114
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Abstract

Cerebral syphilitic gummata are rare granulomatous lesions associated with tertiary syphilis, typically developing several years after the initial infection. Early‑stage syphilis with cerebral gummata and accompanying severe neurological symptoms is rare. Failure to recognize the lesions or delays in diagnosis may lead to marked and potentially irreversible central nervous system injury. In the present study, the case of a 60‑year‑old man with a 6‑month history of syphilis who presented with progressive right‑sided limb weakness and dysarthria is reported. Brain magnetic resonance imaging revealed multiple ring‑enhancing lesions accompanied by extensive perilesional edema. Due to the severity of the symptoms and a notable mass effect, surgical intervention was performed to remove the gummatous lesion, followed by histopathological confirmation of syphilitic granuloma. The patient was subsequently treated with high‑dose intravenous penicillin, which led to notable improvement in neurological function and resolution of the symptoms; follow‑up imaging demonstrated no recurrence of intracranial lesions. In conclusion, the present case illustrates the importance of early recognition and a multidisciplinary approach in the management of neurosyphilis with cerebral gummata. Increased awareness of this rare presentation may facilitate a timely diagnosis and appropriate treatment in similar clinical scenarios.
View Figures

Figure 1

Timeline diagram of the clinical
course. MRI, magnetic resonance imaging.

Figure 2

Preoperative brain magnetic resonance
imaging scans. (A) Axial T1-weighted image demonstrating a
hypointense mass in the left frontal lobe. (B) Axial T2-weighted
image showing the left frontal lobe lesion with extensive
surrounding hyperintense edema. (C) Contrast-enhanced coronal
T1-weighted image revealing prominent ring enhancement of the
lesion. (D) Contrast-enhanced sagittal T1-weighted image
demonstrating the close relationship between the lesion and the
adjacent dura mater.

Figure 3

Intraoperative images of the surgical
resection of the left frontal lobe lesion. (A) Intraoperative view
showing the exposed left frontal lobe lesion without a discernible
capsule. (B) Dissection plane along the margins of the lesion
during surgical separation. (C) Intraoperative image demonstrating
firm adherence of the lesion to the falx cerebri. (D)
Intraoperative view confirming complete removal of the lesion. (E)
Final operative field showing adequate hemostasis after tumor
resection. (F) Gross appearance of the lesion after surgical
resection.

Figure 4

Postoperative pathological images. (A)
The lesion consists of dense inflammatory infiltration composed of
lymphocytes, plasma cells, granulocytes, histiocytes and
fibroblasts. The black arrow indicates features of vasculitis and
the yellow arrows show plasma cells surrounding the vasculitis
(scale bar, 100 µm). (B) Immunohistochemical staining with
anti-syphilis spirochetes antibodies revealed numerous elongated,
curved and spiral shaped brown Treponema pallidum on the
blood vessel walls; black arrows reveal numerous Treponema
pallidum (scale bar, 100 µm).

Figure 5

Follow-up magnetic resonance imaging
scans 3 months postoperatively. (A) Axial T2-weighted image
demonstrating marked reduction of edema in the frontal lobe. (B)
Contrast-enhanced coronal T1-weighted image showing no residual
contrast-enhancing lesion in the surgical area. (C)
Contrast-enhanced sagittal T1-weighted image confirming the absence
of contrast-enhancing lesions at the operative site.
View References

1 

Ghanem KG, Ram S and Rice PA: The modern epidemic of syphilis. N Engl J Med. 382:845–854. 2020.PubMed/NCBI View Article : Google Scholar

2 

Peeling RW, Mabey D, Chen XS and Garcia PJ: Syphilis. Lancet. 402:336–346. 2023.PubMed/NCBI View Article : Google Scholar

3 

Ropper AH: Neurosyphilis. N Engl J Med. 381:1358–1363. 2019.PubMed/NCBI View Article : Google Scholar

4 

Drago F, Merlo G, Ciccarese G, Agnoletti AF, Cozzani E, Rebora A and Parodi A: Changes in neurosyphilis presentation: A survey on 286 patients. J Eur Acad Dermatol Venereol. 30:1886–1900. 2016.PubMed/NCBI View Article : Google Scholar

5 

Fargen KM, Alvernia JE, Lin CS and Melgar M: Cerebral syphilitic gummata: A case presentation and analysis of 156 reported cases. Neurosurgery. 64:568–575, discussioin 575-6. 2009.PubMed/NCBI View Article : Google Scholar

6 

Cushing H: Further concerning a parasympathetic center in the interbrain: VII. The effect of intraventricularly-injected histamine. Proc Natl Acad Sci USA. 18:500–510. 1932.PubMed/NCBI View Article : Google Scholar

7 

Grant FC: A study of the results of surgical treatment in 2,326 consecutive patients with brain tumor. J Neurosurg. 13:479–488. 1956.PubMed/NCBI View Article : Google Scholar

8 

Katsura S, Suzuki J and Wada T: A statistical study of brain tumors in the neurosurgical clinics in Japan. J Neurosurg. 16:570–580. 1959.PubMed/NCBI View Article : Google Scholar

9 

Barthel L, Hetze S, Teuber-Hanselmann S, Chapot V and Sure U: Syphilitic gummata in the central nervous system: A narrative review and case report about a noteworthy clinical manifestation. Microorganisms. 9(906)2021.PubMed/NCBI View Article : Google Scholar

10 

Kanayama S, Nagata S, Akiyama Y, Miyazato Y, Ishikane M, Inoue M, Ohmagari N and Hara T: Cerebral syphilitic gumma in the modern era: A report of an unusual case and brief review of recent published reports. Br J Neurosurg. 38:1283–1288. 2024.PubMed/NCBI View Article : Google Scholar

11 

Ramrakhiani N, Sukhani PK and Dubey R: Neurosyphilis-a forgotten disease: Case reports with ten years follow-up and review of literature. Neurol India. 68:889–893. 2020.PubMed/NCBI View Article : Google Scholar

12 

Baskar D, R Taallapalli AV, Kishore P, Arshad F, Kulanthaivelu K, Nashi S, Rajendran SP, Kulkarni GB and Alladi S: A rare case of neurosyphilis presenting as normal pressure hydrocephalus syndrome. Neurol India. 70:377–379. 2022.PubMed/NCBI View Article : Google Scholar

13 

Sasaki R, Tanaka N, Okazaki T and Yonezawa T: Multiple cerebral syphilitic gummas mimicking brain tumor in a non-HIV-infected patient: A case report. J Infect Chemother. 25:208–211. 2019.PubMed/NCBI View Article : Google Scholar

14 

Drago F, Ciccarese G and Rebora A: Treatment of late-stage syphilis. JAMA. 313(969)2015.PubMed/NCBI View Article : Google Scholar

15 

Zhang W, Xu D, Qin K, Song C, Miao R, Ma X, Kou C and Huang Y: Clinical, radiological, and pathological features of cerebral and spinal syphilitic gumma: A cross-sectional study. Int J Gen Med. 18:4501–4510. 2025.PubMed/NCBI View Article : Google Scholar

16 

Zayet S, Poloni S, Gendrin V, Chanal J, Dupin N and Klopfenstein T: Early neurosyphilis with serofast state. Emerg Microbes Infect. 13(2373305)2024.PubMed/NCBI View Article : Google Scholar

17 

Zhang L, Zhou Y, Chen J, Yan W, Kong Q, Chen P and Sang H: A case of a cerebral syphilitic gumma developed in a few months mimicking a brain tumor in a human immunodeficiency virus-negative patient. Br J Neurosurg. 31:481–483. 2017.PubMed/NCBI View Article : Google Scholar

18 

Forrestel AK, Kovarik CL and Katz KA: Sexually acquired syphilis: Laboratory diagnosis, management, and prevention. J Am Acad Dermatol. 82:17–28. 2020.PubMed/NCBI View Article : Google Scholar

19 

Shen S, Yang R, Wang L, Tang L and Liu B: Multiple intracranial and spinal cord syphilitic gummas in a human immunodeficiency virus-negative man with untreated syphilis: A case report. Medicine (Baltimore). 98(e16887)2019.PubMed/NCBI View Article : Google Scholar

20 

Mu LK, Cheng LF, Ye J, Zhao MY and Wang JL: Cerebral syphilitic gumma misdiagnosed as brain abscess: A case report. World J Clin Cases. 12:650–656. 2024.PubMed/NCBI View Article : Google Scholar

21 

Tsuboi M, Nishijima T, Teruya K, Kikuchi Y, Gatanaga H and Oka S: Cerebral syphilitic gumma within 5 months of syphilis in HIV-infected patient. Emerg Infect Dis. 22:1846–1848. 2016.PubMed/NCBI View Article : Google Scholar

22 

Waugh S, Ranasinghe A, Gomez A, Houston S, Lithgow KV, Eshghi A, Fleetwood J, Conway KME, Reynolds LA and Cameron CE: Syphilis and the host: Multi-omic analysis of host cellular responses to treponema pallidum provides novel insight into syphilis pathogenesis. Front Microbiol. 14(1254342)2023.PubMed/NCBI View Article : Google Scholar

23 

McVey M, Cameron W and MacPherson P: When infections collide-gummatous syphilis in an HIV-infected individual. Int J Infect Dis. (14 Suppl 3):e283–e286. 2010.PubMed/NCBI View Article : Google Scholar

24 

Ramchandani MS, Cannon CA and Marra CM: Syphilis: A modern resurgence. Infect Dis Clin North Am. 37:195–222. 2023.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Ji Y, Liu S, Wang Y, Zhao Y, Cai Z and Li B: A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report. Exp Ther Med 31: 119, 2026.
APA
Ji, Y., Liu, S., Wang, Y., Zhao, Y., Cai, Z., & Li, B. (2026). A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report. Experimental and Therapeutic Medicine, 31, 119. https://doi.org/10.3892/etm.2026.13114
MLA
Ji, Y., Liu, S., Wang, Y., Zhao, Y., Cai, Z., Li, B."A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report". Experimental and Therapeutic Medicine 31.5 (2026): 119.
Chicago
Ji, Y., Liu, S., Wang, Y., Zhao, Y., Cai, Z., Li, B."A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report". Experimental and Therapeutic Medicine 31, no. 5 (2026): 119. https://doi.org/10.3892/etm.2026.13114
Copy and paste a formatted citation
x
Spandidos Publications style
Ji Y, Liu S, Wang Y, Zhao Y, Cai Z and Li B: A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report. Exp Ther Med 31: 119, 2026.
APA
Ji, Y., Liu, S., Wang, Y., Zhao, Y., Cai, Z., & Li, B. (2026). A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report. Experimental and Therapeutic Medicine, 31, 119. https://doi.org/10.3892/etm.2026.13114
MLA
Ji, Y., Liu, S., Wang, Y., Zhao, Y., Cai, Z., Li, B."A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report". Experimental and Therapeutic Medicine 31.5 (2026): 119.
Chicago
Ji, Y., Liu, S., Wang, Y., Zhao, Y., Cai, Z., Li, B."A rare case of early‑onset cerebral syphilitic gummata with severe neurological decline in early‑stage syphilis: A case report". Experimental and Therapeutic Medicine 31, no. 5 (2026): 119. https://doi.org/10.3892/etm.2026.13114
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