A case of pelvic actinomycosis with hepatic actinomycotic pseudotumor.
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.
Kim
Hee Seoung
HS
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Park
Noh Hyun
NH
Park
Keoung Ah
KA
Kang
Soon Beom
SB
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*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D000658:Amoxicillin