This patient presented with a swollen scrotum, which was diagnosed as a syphilitic gumma of the testicle.

Usually appearing during late-staged, tertiary syphilis, gummas, or gummata are a mass of dead and swollen fiber-like tissue representing a localization of T. pallidum bacteria, which can form in the liver, brain, testis, heart, skin, and bone. The gummatous center appears as a rubbery, grayish white region of necrosis. They can manifest as microscopic or large, macroscopic necrotic lesions. Syphilis is known as the “great imitator”, for its manifestations often resemble other disease processes; gummas can be very similar in appearance to other granulomatous inflammatory conditions such as tuberculosis, leprosy, and some fungal infections.

Content Providers(s): CDC/Susan Lindsley, VD