-About one-third of patients with untreated latent syphilis progress to tertiary syphilis 

Manifestations: 

Gummas: granulomatous, erosive, nodular lesions with central necrosis which most commonly affect the skin and bones

-they affect the palate, nasal mucosa, tongue, tonsils, pharynx

-Ulceration of gummas can cause saddle-nose deformity due to erosion of cartilage 

CNS lesions: meningovascular syphilis, paresis, tabes dorsalis 

Cardiovascular lesions: aortitis, aortic valve insufficiency, coronary ostial stenosis, and saccular aneurysm