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When pelvic actinomycosis mimics cervical neoplasia: A diagnostic challenge
Julie Marcadet1, Salma Ayadi2, Pierre-André Mal1
1Gynecology Department, Pitié-Salpêtrière Hospital, 75013 Paris, France.
Abstract:
Pelvic actinomycosis is an uncommon infection caused by Actinomyces israelii, often linked to prolonged intrauterine device (IUD) use. Its clinical and radiologic presentation may closely mimic pelvic malignancies, leading to misdiagnosis and inappropriate management. We report two cases of pelvic actinomycosis initially mistaken for cervical cancer. The first involved a 50-year-old woman with pelvic pain and imaging suggestive of advanced cervical neoplasia; histology revealed Actinomyces infection, and antibiotic therapy led to complete resolution. The second concerned a 76-year-old woman with a cervical mass and metabolic uptake on PET scan, ultimately diagnosed as actinomycotic cervicitis after IUD removal and microbiological confirmation. Both patients improved with prolonged antibiotic treatment. Awareness of this rare entity is essential to prevent unnecessary radical surgery and to ensure timely conservative management.
Insights
Pelvic actinomycosis, a rare infection often linked to intrauterine devices (IUDs), can mimic cancer. Early diagnosis and antibiotic treatment are crucial for recovery, avoiding unnecessary surgery.
Area of Science:
- Gynecology
- Infectious Diseases
- Pathology
Background:
- Pelvic actinomycosis is an uncommon infection caused by Actinomyces israelii.
- It is frequently associated with prolonged intrauterine device (IUD) use.
- The condition can present with symptoms and imaging findings that closely resemble pelvic malignancies, particularly cervical cancer.
