(a) Pathogenesis Syphilis is a chronic infectious disease caused by the syphilis spirochete, which is a kind of venereal disease. It is a systemic infection at the beginning and can involve any organs and tissues in the process of development. Esophageal syphilis is extremely rare, mainly stage III syphilis. (Esophageal syphilis does not differ from syphilitic lesions in other parts of the body, and is primarily a vasculopathy from the beginning to the end of the disease, with the exception of xerostomia. Advanced syphilis is characterized by inflammatory changes and necrosis due to occlusive endarteritis of the small terminal arteries and arterioles. In general, stage III syphilis presents as submucosal gummosis or diffuse inflammation with tissue destruction, both forms of which can lead to erosions and ulcers and the formation of scarring stenoses.