Syphilis of the oropharynx: Case series of “The Great Masquerader”

Ameya Jategaonkar, Jaclyn Klimczak, Jay Agarwal, Arvind Badhey, William M. Portnoy, Angela Damiano, Raymond L. Chai

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objective: Syphilis is a sexually transmitted infection with various presentations. Although, oropharyngeal manifestations are known to occur, the purpose of this study is to present the first case series in which the lesions were initially mistaken for human-papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Methods: A multi-institutional retrospective review. Results: Six cases of oropharyngeal syphilis were initially thought to be secondary to OPSCC due to presentation. Symptoms were vague and exam findings consisted of either a tonsillar or base of tongue mass, or lymphadenopathy. Biopsies were negative for OPSCC. Further workup diagnosed syphilis, with resolution of symptoms and lesions after antibiotic treatment. Conclusions: Head and neck manifestations of syphilis have been reported in the literature. However, this is the first series reporting on oropharyngeal syphilis masquerading as HPV-related OPSCC. Ultimately, otolaryngologists must maintain a high suspicion for syphilis in order to ensure prompt diagnosis and treatment.

Original languageEnglish
Pages (from-to)143-146
Number of pages4
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number2
StatePublished - 1 Mar 2019


  • Oropharyngeal cancer
  • Oropharynx
  • Spirochete
  • Squamous cell carcinoma
  • Syphilis


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