Syphilis mimicking trigeminal schwannoma

A 20-year-old woman presented with a two-month history of temporal headache and right trigeminal nerve palsy. An MRI showed enlargement and contrast enhancement of the right trigeminal nerve, suggestive of a schwannoma (). Cerebrospinal fluid analysis disclosed: 10 cells/mm3, protein 76mg/dl, glucose 50mg/dl and positive Venereal Disease Research Laboratory test (VDRL). Serum VDRL was 1/256 and the Treponema pallidum haemagglutination was positive. She was treated with IV crystalline penicillin G 2.400.000 U/day for 14 days with clinical and radiological improvement [...]