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The foreskin mass was clinically suspicious for squamous cell carcinoma; however, histopathology of both the foreskin mass and inguinal lymph node showed necrotising granulomatous inflammation. Extensive immunohistochemistry testing was inconclusive and could not identify a causative microorganism. Ultimately, serology was positive for <jats:italic>Treponema pallidum<\/jats:italic> and he was treated with intramuscular benzathine penicillin. This is an unusual case, which highlights the importance of extensive investigation for differential diagnoses of penile mass and exemplifies the resurgence of syphilis in developed countries.<\/jats:p>","DOI":"10.1136\/bcr-2020-238539","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T11:55:42Z","timestamp":1615377342000},"page":"e238539","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Necrotising granulomatous mass of the foreskin with inguinal lymphadenopathy: a rare presentation of syphilis"],"prefix":"10.1136","volume":"14","author":[{"given":"Cecile","family":"Pham","sequence":"first","affiliation":[{"name":"Urology, Campbelltown Hospital, Campbelltown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Wang","sequence":"additional","affiliation":[{"name":"Urology, Campbelltown Hospital, Campbelltown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivienne","family":"Lea","sequence":"additional","affiliation":[{"name":"Anatomical Pathology, Liverpool Hospital, Liverpool, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prem","family":"Rathore","sequence":"additional","affiliation":[{"name":"Urology, Campbelltown Hospital, Campbelltown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"2025082707525880000_14.3.e238539.1","first-page":"81","article-title":"Penile augmentation with resultant foreign material granuloma and sequalae","volume":"19","author":"Inn","year":"2012","journal-title":"Malays J Med Sci"},{"key":"2025082707525880000_14.3.e238539.2","unstructured":"Bunker C , Porter W . 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