Tertiary syphilis mimicking hepatic metastases of underlying primary peritoneal serous carcinoma

Figure 1 Abdominopelvic computed tomography scan showing ascites and contrast-enhanced peritoneal nodules.

Figure 2 Microscopic findings of the peritoneal nodules revealed papillary serous adenocarcinoma with infiltrative papillary clusters (A, H&E stain × 40) and tumor nests with characteristic retraction artifacts in the stroma (B, H&E stain × 100).

Figure 3 Computed tomography scan showing two hepatic nodules with peripheral enhancement (arrows).

Figure 4 Liver biopsy specimens revealed an inflammatory cell infiltration among the hepatocytes and sinusoids, and partial abscess formation (A, H&E stain × 100). The inflammatory infiltrate was composed primarily of eosinophils (B, H&E stain × 400).

Figure 5 Computed tomography scan showing two recurrent lesions around the previous operative sites (arrows).

Figure 6 Pathological findings of the specimens from the secondary operation showed chronic inflammation with necrosis. A: A well-demarcated inflammatory nodule was identified within the liver parenchyma (H&E stain × 40); B: Lymphoplasma cell infiltration was also noted in the peripheral portion of the nodule (H&E stain × 100); C: The nodule was filled with inflammatory necrotic debris (H&E stain × 200).