Cerebral syphilitic gumma, first described by Botalli in 1563, is a rare manifestation, typically of tertiary syphilis.

Syphilitic gumma involvement of the central nervous system is extremely rare and frequently misdiagnosed.

Cerebral gummas typically arise from the dura and pia mater over the cerebral convexity or at the base of the brain and produce symptoms similar to those of other intracranial tumors.


Xia et al., report a patient of a cerebral syphilitic gumma resembling a malignant brain tumor in a 62-year-old male. He was first suspected of a malignant brain tumor, but the pathological diagnosis was cerebral syphilitic gumma. This patient with unusual findings illustrates the clinical manifestations, imaging, and therapeutic aspects of cerebral syphilitic gumma 1).


A 59-year-old woman presenting dysarthria showed a mass on her brain computed tomography. She was first suspected of brain tumor, but histological results from surgical resection revealed cerebral gumma due to neurosyphilis. After operation, she presented fever and rash with an infiltration on a chest X-ray. Histological assessment of skin was consistent with syphilis. Fluorescent treponemal antibody absorbed test IgG in cerebrospinal fluid was positive. She was successfully treated with ceftriaxone for 14 days 2).

Xia DY, Zhu MF, Liu CG, Dai Y, Li ZB, Jiang XC, Xu SS. Cerebral Syphilitic Gumma Misdiagnosed as a Malignant Brain Tumor. J Craniofac Surg. 2016 Oct 14. PubMed PMID: 27755440.
Yoon YK, Kim MJ, Chae YS, Kang SH. Cerebral syphilitic gumma mimicking a brain tumor in the relapse of secondary syphilis in a human immunodeficiency virus-negative patient. J Korean Neurosurg Soc. 2013 Mar;53(3):197-200. doi: 10.3340/jkns.2013.53.3.197. Epub 2013 Mar 31. PubMed PMID: 23634274; PubMed Central PMCID: PMC3638277.
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