Mu Li-Kun, Cheng Li-Feng, Ye Jing, Zhao Meng-Yan, Wang Jin-Long
Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying 257099, Shandong Province, China.
World J Clin Cases. 2024 Jan 26;12(3):650-656. doi: 10.12998/wjcc.v12.i3.650.
Cerebral syphilitic gumma is a relatively rare clinical disease. Its clinical manifestations are non-specific, and the imaging manifestations are similar to other intracranial occupying lesions, often misdiagnosed as tumors or abscesses. There are few reports on this disease in the relevant literature. To our knowledge, we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases.
We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics. The clinical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported. Clinical manifestations, classifications, and diagnostic points were retrospectively analyzed. The patient was admitted to the hospital with fever and limb weakness. Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum gelatin agglutination test. The patient was misdiagnosed as having a brain abscess and underwent a craniotomy. A postoperative pathological diagnosis of syphilis gumma was made. The patient improved and was discharged after penicillin anti-syphilis treatment. Follow-up recovery was satisfactory.
Cerebral syphilitic gumma is rare in clinical practice, and it is often misdiagnosed and missed. Clinical diagnosis should be considered in combination with multiple examinations.
脑梅毒瘤是一种相对罕见的临床疾病。其临床表现不具有特异性，影像学表现与其他颅内占位性病变相似，常被误诊为肿瘤或脓肿。相关文献中关于该疾病的报道较少。据我们所知，我们报道了首例被误诊为脑脓肿的脑梅毒瘤病例。我们报告该病例，为临床医生提供有关神经梅毒疾病的有用信息。
我们报告该病例以探讨脑梅毒瘤的诊断要点，并试图通过让医生了解神经梅毒特征来降低误诊和漏诊率。报告了1例脑梅毒瘤患者的临床诊断和治疗情况。对其临床表现、分类及诊断要点进行回顾性分析。该患者因发热和肢体无力入院。脑部磁共振成像显示多个占位性病变，血清明胶凝集试验呈阳性。患者被误诊为脑脓肿并接受了开颅手术。术后病理诊断为梅毒瘤。患者经青霉素抗梅毒治疗后病情好转并出院。随访恢复情况良好。
脑梅毒瘤在临床实践中较为罕见，常被误诊和漏诊。临床诊断应结合多项检查综合考虑。
