title: A case of pelvic actinomycosis with hepatic actinomycotic pseudotumor.
abstract: Pelvic actinomycosis in women most commonly occurs during ascending infections, usually associated with intrauterine devices (IUDs). However, secondary hepatic actinomycosis is very rare. A 47-year-old woman using IUDs for 18 years was referred under the impression of ovarian cancer. Further investigation revealed a hepatic tumor diagnosed as an inflammatory pseudotumor by fine needle aspiration biopsy, and a pelvic mass diagnosed as pelvic actinomycosis by sulfur granules in bilateral adnexa gained by an explorative laparotomy. Long-term therapy with high-dose intravenous penicillin and oral amoxicillin resulted in clinical and radiological improvement. The management of pelvic actinomycosis is based on a medical approach, although it sometimes requires surgical intervention. However, the necessity for surgical treatment is controversial in cases of secondary hepatic actinomycosis.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Hee Seoung
authors.initials: HS
authors.lastname: Kim
authors.forename: Noh Hyun
authors.initials: NH
authors.lastname: Park
authors.forename: Keoung Ah
authors.initials: KA
authors.lastname: Park
authors.forename: Soon Beom
authors.initials: SB
authors.lastname: Kang
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D008107:Liver Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D000658:Amoxicillin