Unilateral ulcerated tonsillar tumor with bilateral lymphadenopathy due to syphilis mimicking oropharyngeal cancer: A case report

Abstract

Syphilis is a systemic infection caused by Treponema pallidum, and acquired syphilis is a wellknown sexually transmitted infection with a variety of symptoms that hinder accurate diagnosis. We herein reported the case of a 60-year-old male with right unilateral syphilitic tonsillitis presenting as an ulcerated lesion accompanied with bilateral lymphadenopathy; metastatic oropharyngeal cancer was initially considered. Blood tests before surgery indicated syphilitic infection; however, because of the atypical lesion presentation in the absence of accompanying genital, skin, or systemic symptoms, tonsillectomy was performed to exclude malignancy. Syphilis is not commonly encountered in otorhinolaryngology; thus syphilis should be included in differential diagnosis for oral lesions of unknown origin. Critically, diagnostic surgery in addition to systemic physical examination is necessary to avoid misdiagnosis; failure of antibiotic therapy for syphilis without confirmed pathological diagnosis in true cases of oropharyngeal cancer may consequently lead to a delay in appropriate treatment and progression of malignancy.