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Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report

BACKGROUND: Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. Recently, its incidence has been increasing worldwide. We encountered a young woman who presented with induration mimicking squamous cell carcinoma in the lower lip, without major medical conditions....

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Autores principales: Asai, Satomi, Kaneko, Akihiro, Matsuda, Tsukumi, Takanashi, Noboru, Doi, Mika, Atsumi, Haruyo, Ogura, Go, Nakamura, Naoya, Miyachi, Hayato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641852/
https://www.ncbi.nlm.nih.gov/pubmed/33143735
http://dx.doi.org/10.1186/s13256-020-02547-x
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author Asai, Satomi
Kaneko, Akihiro
Matsuda, Tsukumi
Takanashi, Noboru
Doi, Mika
Atsumi, Haruyo
Ogura, Go
Nakamura, Naoya
Miyachi, Hayato
author_facet Asai, Satomi
Kaneko, Akihiro
Matsuda, Tsukumi
Takanashi, Noboru
Doi, Mika
Atsumi, Haruyo
Ogura, Go
Nakamura, Naoya
Miyachi, Hayato
author_sort Asai, Satomi
collection PubMed
description BACKGROUND: Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. Recently, its incidence has been increasing worldwide. We encountered a young woman who presented with induration mimicking squamous cell carcinoma in the lower lip, without major medical conditions. CASE PRESENTATION: A 25-year-old Japanese woman presented with a 1-month history of a painless induration in her lower lip. Because squamous cell carcinoma was suspected, a preoperation work up was performed, including laboratory tests, an ultrasonographic examination, and a biopsy. The ultrasonography findings showed an oval-shaped 17 × 11 × 12 mm tumor-like lesion with heterogeneous internal echo and an indistinct border. A pressure test and color Doppler sonography revealed that the lesion was soft with a very abundant blood flow. These findings suggested the possibility of underlying inflammatory causes rather than a neoplastic tumor. Serology tests for syphilis, including the anti-Treponema pallidum antibody and reactive rapid plasma reagin tests, were positive. The biopsy revealed no malignancy. Finally, she was diagnosed as having primary syphilis and treated with amoxicillin for 28 days. The rapid plasma reagin value gradually decreased and the initial induration in her lower lip disappeared. CONCLUSION: This case highlights the need for prompt examinations for possible underlying infective causes, such as syphilis, when seeing a painless induration with ulcer in the lip. Ultrasonography was helpful in the differential diagnosis of a tumor-like lesion and should be included in addition to syphilis serology tests, such as anti-Treponema pallidum antibody and rapid plasma reagin tests.
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spelling pubmed-76418522020-11-05 Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report Asai, Satomi Kaneko, Akihiro Matsuda, Tsukumi Takanashi, Noboru Doi, Mika Atsumi, Haruyo Ogura, Go Nakamura, Naoya Miyachi, Hayato J Med Case Rep Case Report BACKGROUND: Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. Recently, its incidence has been increasing worldwide. We encountered a young woman who presented with induration mimicking squamous cell carcinoma in the lower lip, without major medical conditions. CASE PRESENTATION: A 25-year-old Japanese woman presented with a 1-month history of a painless induration in her lower lip. Because squamous cell carcinoma was suspected, a preoperation work up was performed, including laboratory tests, an ultrasonographic examination, and a biopsy. The ultrasonography findings showed an oval-shaped 17 × 11 × 12 mm tumor-like lesion with heterogeneous internal echo and an indistinct border. A pressure test and color Doppler sonography revealed that the lesion was soft with a very abundant blood flow. These findings suggested the possibility of underlying inflammatory causes rather than a neoplastic tumor. Serology tests for syphilis, including the anti-Treponema pallidum antibody and reactive rapid plasma reagin tests, were positive. The biopsy revealed no malignancy. Finally, she was diagnosed as having primary syphilis and treated with amoxicillin for 28 days. The rapid plasma reagin value gradually decreased and the initial induration in her lower lip disappeared. CONCLUSION: This case highlights the need for prompt examinations for possible underlying infective causes, such as syphilis, when seeing a painless induration with ulcer in the lip. Ultrasonography was helpful in the differential diagnosis of a tumor-like lesion and should be included in addition to syphilis serology tests, such as anti-Treponema pallidum antibody and rapid plasma reagin tests. BioMed Central 2020-11-04 /pmc/articles/PMC7641852/ /pubmed/33143735 http://dx.doi.org/10.1186/s13256-020-02547-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Asai, Satomi
Kaneko, Akihiro
Matsuda, Tsukumi
Takanashi, Noboru
Doi, Mika
Atsumi, Haruyo
Ogura, Go
Nakamura, Naoya
Miyachi, Hayato
Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
title Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
title_full Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
title_fullStr Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
title_full_unstemmed Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
title_short Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
title_sort sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641852/
https://www.ncbi.nlm.nih.gov/pubmed/33143735
http://dx.doi.org/10.1186/s13256-020-02547-x
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