Work

Case Report: When syphilis imitates cancer: a case of misdiagnosed cutaneous T-cell lymphoma

Year: 2026

Type: article

Abstract: Syphilis is an infectious disease caused by Treponema pallidum, which is regarded as one of the most significant imitators in daily clinical practice. Its manifestations are various, comprising numerous autoimmune, inflammatory, and neoplastic disorders. Here we present a case of a 27-year-old male initially suspected of cutaneous T-cell lymphoma (CTCL) based on lymphadenopathy, systemic weight loss, ulcerative cutaneous lesions, and fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) findings of hypermetabolic nodes above and below the diaphragm. Histopathological analysis suggested pleomorphic lymphoid proliferation, while imaging supported the suspicion of malignancy. However, subsequent biopsies revealed plasmacytic and lymphocytic infiltration without clonality, and treponemal serologies confirmed secondary syphilis. The patient was referred for anti-treponemal therapy resulting in the resolution of the initial symptoms. This case presents how syphilis can closely imitate hematologic malignancy, particularly CTCL, both clinically and histopathologically. We also review and prepare a summary of published reports of syphilis mimicking malignancies and propose a structured diagnostic algorithm. We believe that the early inclusion of syphilis in differential diagnosis is critical to avoid misdiagnosis and delays in initiating appropriate therapy.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2026.1730564

Authors: Ugo Giordano, Jacek Kwiatkowski, Krzysztof Zduniak, Monika Mordak-Domagała, Zuzanna Dybko, Jarosław Dybko

Institutions: Wroclaw Medical University, Wrocław University of Science and Technology

Language: English

Topic: Cutaneous lymphoproliferative disorders research

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801