# Case Report: The great mimicker: cerebral syphilitic gumma

## TL;DR

A rare case of cerebral syphilitic gumma was misdiagnosed as a brain tumor, highlighting the need to consider neurosyphilis in similar cases.

## Contribution

This case report adds to the limited literature on cerebral syphilitic gumma and emphasizes its diagnostic challenges.

## Key findings

- Cerebral syphilitic gumma was initially misdiagnosed as a brain malignancy due to imaging similarities.
- Intraoperative and histopathological findings confirmed the correct diagnosis of neurosyphilis.
- The case underscores the importance of including neurosyphilis in the differential diagnosis of intracranial lesions.

## Abstract

Cerebral syphilitic gumma, a rare form of neurosyphilis, poses significant diagnostic challenges due to its imaging similarities to gliomas and brain metastases. This report details the diagnostic and therapeutic journey of a patient with cerebral syphilitic gumma admitted to the Department of Neurosurgery, Nanjing Medical University Affiliated Huaian First Hospital in February 2025. Initially misdiagnosed with a brain malignancy, the accurate diagnosis was established intraoperatively and confirmed postoperatively through histopathological examination. This case highlights the importance of considering neurosyphilis in differential diagnoses of intracranial lesions, especially when conventional imaging and clinical presentations are inconclusive.