Oral Syphilitic Lesion Mimicking Squamous Cell Carcinoma: A Case Report
Alan Alves Machado
Federal University of Santa Catarina, Florianópolis, Brazil.
Túlio Silva Rosa
*
Oral Diagnosis in the Postgraduate Program in Dentistry at the Federal University of Santa Catarina (PPGO/UFSC), Florianópolis, Brazil.
Thamylla Martírios Santos
Graduated in Dentistry, Presidente Antônio Carlos Tocantins University Center - UNITPAC/Afya, Araguaína, Brazil.
Raian dos Santos Souza
Graduated in Dentistry, Presidente Antônio Carlos Tocantins University Center - UNITPAC/Afya, Araguaína, Brazil.
Ana Lúcia Roselino Ribeiro
Undergraduate Professor at the Presidente Antônio Carlos Tocantins University Center - UNITPAC/Afya, Araguaína, Brazil.
Angélica Pereira Rocha
Undergraduate Professor at the Presidente Antônio Carlos Tocantins University Center - UNITPAC/Afya, Araguaína, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Syphilis is a sexually transmitted infection that may manifest in the oral cavity, often mimicking malignant conditions such as oral squamous cell carcinoma (OSCC), particularly in patients with high-risk profiles for malignancy.
Case Presentation: This report describes a 45-year-old female patient with a history of chronic smoking and alcohol consumption who presented with an ulcerated lesion on the lateral border of the tongue, clinically suggestive of OSCC. Despite the initial suspicion of malignancy, histopathological and immunohistochemical evaluations revealed a diagnosis of secondary syphilis.
Findings: Microscopic analysis showed stratified parakeratinized epithelium with intraepithelial microabscesses and a dense perivascular lymphoplasmacytic infiltrate. Immunohistochemistry was strongly positive for Treponema pallidum, and serological testing (VDRL) confirmed active syphilitic infection.
Conclusion: This case underscores the need to consider infectious diseases in the differential diagnosis of suspicious oral lesions. A comprehensive diagnostic approach—including serology, histopathology, and immunohistochemistry—is essential to avoid misdiagnosis and to guide appropriate management.
Keywords: Syphilis, diagnosis, oral squamous cell carcinoma, oral lesions