Abstract: The 50-year-old female patient had a history of syphilis for 17 months and paroxysmal headaches for 4 months. Seventeen months ago, the patient was diagnosed as primary syphilis, and received regular treatment and regular visit. The RPR titer decreased by 4 times and the rash subsided for 6-month treatment. Ten months ago, syphilis recurred, and given the regular treatment, the rash subsided after treatment again. Four months ago, he occurred paroxysmal headache, and MRI showed a mass on the right side of head, which was considered as a metastatic tumor. The patient was treated with surgery and the histological examination showed syphilitic gumma. Headache disappeared then the patient was given antisyphilitic treatment.

Key words: early syphilis, gumma