Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7798-7804
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7798
Gastric syphilis mimicking gastric cancer: A case report
Yan-Mei Lan, Shang-Wen Yang, Mu-Gen Dai, Bin Ye, Fei-Yun He
Yan-Mei Lan, Shang-Wen Yang, Mu-Gen Dai, Bin Ye, Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Fei-Yun He, Department of Gastroenterology, Lishui Chinese Medicine Hospital, Lishui 323000, Zhejiang Province, China
Author contributions: Lan YM and Yang SW contributed equally to this work; Lan YM, Yang SW, Dai MG, Ye B, and He FY designed the research study; Lan YM, Yang SW, Dai MG, Ye B, and He FY performed the research; Lan YM, Yang SW, Dai MG, Ye B, and He FY analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Supported by the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, No. 2020ZH080.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei-Yun He, MD, Chief Physician, Doctor, Department of Gastroenterology, Lishui Chinese Medicine Hospital, No. 800 Zhongshan Road, Lishui 323000, Zhejiang Province, China. 408252097@qq.com
Received: February 22, 2021
Peer-review started: February 22, 2021
First decision: May 6, 2021
Revised: May 14, 2021
Accepted: August 10, 2021
Article in press: August 10, 2021
Published online: September 16, 2021
Processing time: 199 Days and 20.9 Hours
Abstract
BACKGROUND

The nonspecific clinical, radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases. The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.

CASE SUMMARY

A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week, which was aggravated for two days. The patient had been sexually active with the same male partner for the past years, but her partner was promiscuous. Abdominal contrast-enhanced computed tomography (CT) and positron emission tomography/CT suggested gastric cancer. The gastroscopy revealed an antral gastric ulcer with gastric retention, and also suggested gastric cancer. But no cancer cells were found in the biopsies taken during the two gastroscopies. Treponema pallidum (T. pallidum) antibodies: ELISA positive, rapid plasma reagin titer 1:16. Hematoxylin and eosin (HE) stain showed macrophage infiltration in the lamina propria. Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T. pallidum. The patient was finally diagnosed with gastric syphilis.

CONCLUSION

Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer. Penicillin can relieve symptoms of gastric syphilis.

Keywords: Syphilis gastritis; Misdiagnosis; Gastric cancer; Endoscopy; Case report

Core Tip: Syphilitic gastritis is one of the rare manifestations of syphilis, which has not been recognized by doctors. The majority of patients affected by syphilitic gastritis lack other signs and symptoms of syphilis and have no previous history of primary infection. The diagnosis of syphilitic gastritis depends on the combination of medical history, physiological, radiological, serological and pathological findings. According to the clinical stage of syphilis, penicillin treatment is effective.