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Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient

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Abstract

Purpose

Multi-syphilitic gummas in pituitary and cerebellopontine angle (CPA) are extremely rare and easily misdiagnosed especially in patients with antibiotic abuse. We write this paper for clinicians to better understanding of cerebral gumma.

Methods

We report a patient with syphilitic gummas in pituitary and left CPA. The definite diagnosis is made by histopathology after surgery.

Results

A 49-years-old woman suffered from headaches with tinnitus and hypoacusis in left ear. She was diagnosed with syphilis but untreated. There were no chancre and rashes in the course of disease. Syphilis serological tests were positive. Brain MRI found two masses located in the left CPA and hypophysial fossa. The two masses were removed successively. We found a large number of Treponemapallidum in paraffin-embedded specimens by immunohistochemical staining.

Conclusions

Syphilitic gummas in pituitary and CPA are similar to benign or malignant brain tumors, easily leading to misdiagnosis. Gumma should be considered in differential diagnosis when a patient has unexplained nervous system symptoms or signs and imaging findings suggest intracranial mass in syphilis seropositive patients.

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Funding

This study is supported by the Project Program of Neurosurgical Clinical Research Center of Sichuan Province, Science and Technology Foundation of Southwest Medical University (2017-ZRQN-180, 2017-ZRQN-110). This work was also supported by the Affiliated Hospital of Southwest Medical University under (Grant No. 171420). The mechanism of the HIF-1 mediating the angiogenesis of the aged rat subjected to the cerebral ischemic injury.

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Author notes

  1. Kaiguo Xia and Zhangchao Guo are co-first authors.

Authors and Affiliations

  1. Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China

    Kaiguo Xia, Zhangchao Guo, Xiangguo Xia, Yang Ming, Ligang Chen, Xianglong Li & Chuanhong Zhong

  2. Neurosurgical Clinical Medical Research Center of Sichuan Province, Luzhou, 646000, People’s Republic of China

    Kaiguo Xia, Zhangchao Guo, Xiangguo Xia, Yang Ming, Ligang Chen, Xianglong Li & Chuanhong Zhong

Authors
  1. Kaiguo Xia
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  2. Zhangchao Guo
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  3. Xiangguo Xia
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  4. Yang Ming
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  5. Ligang Chen
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  6. Xianglong Li
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  7. Chuanhong Zhong
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Correspondence to Chuanhong Zhong.

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Xia, K., Guo, Z., Xia, X. et al. Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient. Pituitary 23, 253–257 (2020). https://doi.org/10.1007/s11102-020-01033-3

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  • DOI: https://doi.org/10.1007/s11102-020-01033-3

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