[Primary syphilitic lesion mimicking penile cancer. Atypical manifestation with an unconventional diagnostic approach]. / Syphilitischer Primäraffekt unter dem Bild eines Peniskarzinoms. Atypische Manifestation mit ungewöhnlichem diagnostischen Weg.

ABSTRACT

Syphilis is the great imitator in medicine. Correct diagnosis of this disease can be quite difficult nowadays, after years of rare occurrence but current increasing incidence. Atypical manifestations of syphilis are often misinterpreted and lead to incorrect diagnosis and inappropriate therapy. We present the case of a 48-year-old man with recurrent penile ulcers and indurations that would temporarily heal with oral antibiotics. The most recent lesion had lasted longer than 6 weeks. Because of unsuccessful antibiotic and antiseptic treatment, we operated on the patient, suspecting penile cancer. The diagnosis of syphilis was finally performed by histology, with evolving exanthema and positive serological tests in the meantime. This case report is intended to emphasize the increased need to consider syphilis in the differential diagnosis.