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Actinomycosis mimicking a pelvic malignancy. A case report.
J Reprod Med. 2000 Jun; 45(6):515-8.JR

Abstract

BACKGROUND

Pelvic actinomycosis is difficult to diagnose preoperatively. The chronic infection is locally infiltrative and causes a profound induration of infected tissue planes. This induration, combined with absence of fever and leukocytosis, can mimic a pelvic malignancy.

CASE

A 55-year-old woman was diagnosed with a pelvic mass after a two-month history of intermittent lower abdominal pain. The patient had had an intrauterine device for 12 years; it was removed two months prior to an exploratory laparotomy for the symptomatic mass. The mass was highly suggestive of colorectal cancer, with the rectosigmoid colon indurated and adherent to the uterus and sacrum. The induration of the colon extended caudally to within 3 cm of the anal verge. An abdominoperineal resection was performed along with a total abdominal hysterectomy, bilateral salpingo-oophorectomy and colostomy. Pathology revealed acute and chronic endometritis, left tuboovarian abscess and extensive, acute inflammation of the rectosigmoid colon without evidence of diverticuli. Actinomycosis was diagnosed based on the characteristic sulphur granules seen on hemotoxylin and eosin staining.

CONCLUSION

Actinomycosis can mimic pelvic and abdominal malignancies. Surgeons should be aware of this infection to potentially spare women morbidity from excessive surgical procedures.

Authors+Show Affiliations

Department of Gynecologic Oncology, University of Oklahoma Health Science Center, Oklahoma City 73190, USA. dennis-scribner@uokhsc.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

10900590

Citation

Scribner, D R., et al. "Actinomycosis Mimicking a Pelvic Malignancy. a Case Report." The Journal of Reproductive Medicine, vol. 45, no. 6, 2000, pp. 515-8.
Scribner DR, Baldwin J, Johnson GA. Actinomycosis mimicking a pelvic malignancy. A case report. J Reprod Med. 2000;45(6):515-8.
Scribner, D. R., Baldwin, J., & Johnson, G. A. (2000). Actinomycosis mimicking a pelvic malignancy. A case report. The Journal of Reproductive Medicine, 45(6), 515-8.
Scribner DR, Baldwin J, Johnson GA. Actinomycosis Mimicking a Pelvic Malignancy. a Case Report. J Reprod Med. 2000;45(6):515-8. PubMed PMID: 10900590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Actinomycosis mimicking a pelvic malignancy. A case report. AU - Scribner,D R,Jr AU - Baldwin,J, AU - Johnson,G A, PY - 2000/7/20/pubmed PY - 2001/2/28/medline PY - 2000/7/20/entrez SP - 515 EP - 8 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 45 IS - 6 N2 - BACKGROUND: Pelvic actinomycosis is difficult to diagnose preoperatively. The chronic infection is locally infiltrative and causes a profound induration of infected tissue planes. This induration, combined with absence of fever and leukocytosis, can mimic a pelvic malignancy. CASE: A 55-year-old woman was diagnosed with a pelvic mass after a two-month history of intermittent lower abdominal pain. The patient had had an intrauterine device for 12 years; it was removed two months prior to an exploratory laparotomy for the symptomatic mass. The mass was highly suggestive of colorectal cancer, with the rectosigmoid colon indurated and adherent to the uterus and sacrum. The induration of the colon extended caudally to within 3 cm of the anal verge. An abdominoperineal resection was performed along with a total abdominal hysterectomy, bilateral salpingo-oophorectomy and colostomy. Pathology revealed acute and chronic endometritis, left tuboovarian abscess and extensive, acute inflammation of the rectosigmoid colon without evidence of diverticuli. Actinomycosis was diagnosed based on the characteristic sulphur granules seen on hemotoxylin and eosin staining. CONCLUSION: Actinomycosis can mimic pelvic and abdominal malignancies. Surgeons should be aware of this infection to potentially spare women morbidity from excessive surgical procedures. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/10900590/Actinomycosis_mimicking_a_pelvic_malignancy__A_case_report_ L2 - http://www.diseaseinfosearch.org/result/414 DB - PRIME DP - Unbound Medicine ER -