Syphilis of the oropharynx: Case series of “The Great Masquerader”

Publication date: Available online 16 January 2019

Source: American Journal of Otolaryngology

Author(s): Ameya Jategaonkar, Jaclyn Klimczak, Jay Agarwal, Arvind Badhey, William M. Portnoy, Angela Damiano, Raymond L. Chai

Abstract

Objective

Syphilis is a sexually transmitted infection with various presentations. Although, oropharyngeal manifestations are known to occur, the purpose of this study is to present the first case series in which the lesions were initially mistaken for human-papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC).

Methods

A multi-institutional retrospective review.

Results

Six cases of oropharyngeal syphilis were initially thought to be secondary to OPSCC due to presentation. Symptoms were vague and exam findings consisted of either a tonsillar or base of tongue mass, or lymphadenopathy. Biopsies were negative for OPSCC. Further workup diagnosed syphilis, with resolution of symptoms and lesions after antibiotic treatment.

Conclusions

Head and neck manifestations of syphilis have been reported in the literature. However, this is the first series reporting on oropharyngeal syphilis masquerading as HPV-related OPSCC. Ultimately, otolaryngologists must maintain a high suspicion for syphilis in order to ensure prompt diagnosis and treatment.

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