Rectal cancer or rectal chancre? Beware of primary syphilis.

The prevalence of sexually transmitted diseases (STD) has risen in recent years [Brown AE, Sadler KE, Tomkins SE, McGarrigle CA, LaMontagne DS, Goldberg D, et al. Recent trends in HIV and other STIs in the United Kindom: data to the end of 2002. Sex Transm Infect 2004;80:159-66]. Homosexually active men have frequent intestinal and rectal symptoms due to sexually acquired gastrointestinal infections [Surawicz CM, Goodell SE, Quinn TC, Roberts PL, Corey L, Holmes KK, et al. Spectrum of rectal biopsy abnormalities in homosexual men with intestinal symptoms. Gastroenterology 1986;91:651-9]. The number of reported cases of primary syphilis is increasing especially among this group of people [Goh BT. Syphilis in adults. Sex Transm Infect 2005;81:448-52 ]. We herein describe a case of a young man with a primary syphilitic rectal localization mimicking rectal cancer.