Gummatous Syphilis: A Rare Entity Mimicking Carcinoma Penis

OBJECTIVE To describe a rare case of gummatous syphilis of the penis with urethrocutaneous fistula mimicking penile carcinoma causing a diagnostic dilemma. METHOD A 54 year old man presented with an ulcerative lesion on glans penis. Patient was managed with partial penectomy in view of erosive growth giving rise to urethrocutaneous fistula. RESULTS Histopathology showed granulation tissue, necrotizing vasculitis and epithelioid cell granuloma. Immunohistochemistry stained positive for Treponema and patient was treated accordingly. CONCLUSION Syphilis is rarely encountered in daily clinical practice in the penicillin era. Despite a negative serology and the clinical picture highly suggestive of malignancy, the histopathology helped in clinching the rare diagnosis. UROLOGY 146: e8-e9, 2020. (c) 2020 Elsevier Inc.