Gummatous Syphilis Mimicking Malignant Bone Tumor on FDG PET/CT

A 47-year-old woman suffered worsening pain in the waist and numbness in the right thigh for 1 month. MRI was performed to determine the cause, which detected an osteolytic lesion in the T12 vertebral body, suggestive of possible bone metastasis. FDG PET/CT scan was undertaken to detect the primary tumor, which only showed the same isolated lesion in the T12 without any other abnormal hypermetabolic lesion. The pathology following vertebrectomy revealed granulomatous infection. The diagnosis of osseous syphilis was eventually made following a subsequent positive Treponema pallidum serological test. Received for publication October 23, 2019; revision accepted November 27, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Quan-shi Wang, MD, PhD, PET Center, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, Guangdong 510515, China. E-mail: wqslph@163.net. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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