Peeters L, Van Vaerenbergh W, Van der Perre C, Lagrange W, Verbeke M
Department of Gastroenterology, H Hart Hospital, Lier, Belgium.
Acta Gastroenterol Belg. 2005 Oct-Dec;68(4):435-9.
We report a rare case of tertiary syphilis (hepatic gummata, asymptomatic neurosyphilis and iridocyclitis) in a 47 year old female patient. Our patient suffered from a troubled sight, pain in the right hypochondrium, one enlarged submandibular lymph node, an elevated sedimentation rate, disturbed liver tests and two hepatic lesions upon abdominal computed tomography. The diagnosis was based upon a liver biopsy and a positive Treponema Pallidum haemagglutination test. The patient was treated with doxycyclin. After treatment the sedimentation rate and liver tests normalised and the hepatic lesions disappeared leaving a small 'scar' on CT-scan; at the end she still complained of a decreased sight. We conclude that syphilitic gummata of the liver have a favourable prognosis when the diagnosis is made early. One has to differentiate with hepatic abscesses, primary tumours and metastases.
我们报告了一例罕见的三期梅毒病例（肝梅毒瘤、无症状神经梅毒和虹膜睫状体炎），患者为一名47岁女性。我们的患者有视力问题、右季肋部疼痛、一个下颌下淋巴结肿大、血沉升高、肝功能检查异常以及腹部计算机断层扫描显示两个肝脏病变。诊断基于肝活检和梅毒螺旋体血凝试验阳性。患者接受了强力霉素治疗。治疗后血沉和肝功能检查恢复正常，肝脏病变消失，CT扫描上留下一个小“疤痕”；最后她仍抱怨视力下降。我们得出结论，早期诊断的肝脏梅毒瘤预后良好。必须与肝脓肿、原发性肿瘤和转移瘤相鉴别。
