Aims: To report an unusual case of syphilis affecting the tonsil and to review the literature on the subject.
Case description: A 60 year-old Caucasian man presented a swelling of the right side of the neck, and hiponasal voice, four months following a surgery to remove an adenoma of the left submandibular gland. The physical examination showed cervical lymphadenopathy, and a computed tomography scan revealed a cervical mass. Fine-needle aspiration failed to rule out lymphoepithelioma. The right tonsil was clearly pathological and an extended right tonsillectomy was undertaken. A diagnosis of syphilis was established based on pathological analysis combined with blood tests results.
Conclusions: While many chancres appear on the genitals, they may be seen anywhere on the body. The hallmark of syphilis is the absence of pain and the patient’s feeling of a lump in the throat. Although infrequent, syphilis should enter in the differential diagnosis of unilateral tonsillar hypertrophy.