Abdominal lump with a rare pathology

Actinomycosis is one of the rarest pathologies causing intra-abdominal lump in the normal population. Diagnosis is often difficult because of the least suspicion and failure in the pre-operative diagnosis even by taking the aid of modern imaging techniques like Ultrasonogram, CT scan or MRI. Even FNAC may be misleading because of the technical problems and proper interpretation of cytology. Diagnosis is usually made during laparotomy by an experienced Surgeon and finally by the histopathological examination of the resected specimen. We have come across three patients with actinomycosis presenting with intra-abdominal lumps, two as appendicular lumps and 3rd one as a lump of left colonic origin in our institute over the last two years. Ultrasonogram examination revealed lump of gut origin in all the three cases. FNAC in one case revealed the lump as a low grade sarcoma. Laparotomy, excision and or resection of the lumps along with the segment of involved gut with subsequent histopathology revealed these cases as actinomycosis. We report these cases for its extreme rarity and a puzzling pre-operative diagnostic dilemma.