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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Multi-syphilitic gummas in pituitary and cerebellopontine angle in a patient
Kaiguo Xia1,2, Zhangchao Guo1,2, Xiangguo Xia1,2
1Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China.
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.
