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Abdominal-pelvic actinomycosis mimicking malignant neoplasm
Teresa Pusiol1, Doriana Morichetti, Corrado Pedrazzani
1Section of Cytopathology, Institute of Anatomic Pathology, Rovereto Hospital, 38068 Rovereto, Italy. teresa.pusiol@apss.tn.it
Infectious Diseases in Obstetrics and Gynecology
|September 10, 2011
Summary
Abdominal-pelvic actinomycosis, a rare condition often misdiagnosed, can present as a challenging pelvic mass. Early consideration in intrauterine device users is crucial for accurate diagnosis and treatment.
Area of Science:
- Medical Mycology
- Surgical Pathology
- Gynecologic Oncology
Background:
- Abdominal-pelvic actinomycosis is a rare bacterial infection caused by Actinomyces species, often mimicking other pelvic pathologies.
- Preoperative diagnosis can be challenging due to its nonspecific presentation and tendency to form masses.
- Intrauterine devices (IUDs) are a known risk factor for pelvic actinomycosis.
Observation:
- A 46-year-old female with a 3-year IUD history presented with a retroperitoneal mass on CT scan.
- The mass extended from the right kidney to the pelvis, involving multiple adjacent organs.
- Surgical resection revealed inflammatory granulomatous tissue with characteristic Actinomyces sulfur granules.
Findings:
- Histopathological examination confirmed abdominal-pelvic actinomycosis with a coexisting right tubo-ovarian abscess.
- The patient underwent successful surgical management including right hemicolectomy and salpingo-oophorectomy.
- Postoperative penicillin therapy for six months resulted in an uneventful recovery.
Implications:
- This case highlights the importance of considering actinomycosis in the differential diagnosis of pelvic masses, particularly in IUD users.
- Prompt diagnosis and appropriate antibiotic treatment are essential for favorable outcomes.
- Further research into the pathogenesis and diagnostic markers of abdominal-pelvic actinomycosis is warranted.
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