title: Abdominal-pelvic actinomycosis mimicking malignant neoplasm.
abstract: Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device.
authors: Section of Cytopathology, Institute of Anatomic Pathology, Rovereto Hospital, 38068 Rovereto, Italy. teresa.pusiol@apss.tn.it
authors: Teresa
authors: T
authors: Pusiol
authors: Doriana
authors: D
authors: Morichetti
authors: Corrado
authors: C
authors: Pedrazzani
authors: Francesco
authors: F
authors: Ricci
mesh_terms: D000005:Abdomen / Q000382:microbiology / Q000601:surgery; D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D010388:Pelvis / Q000382:microbiology / Q000601:surgery; D010406:Penicillins / Q000627:therapeutic use; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
chemical_list: D010406:Penicillins