Abdominopelvic Actinomycosis Mimicking Ovarian Cancer

Abstract

Objective: Abdominopelvic masses due to unusual causes (actinomycosis, tuberculosis, etc.) are great mimickers of abdominal or pelvic malignancies, especially ovarian cancer. Case Report: A 29-year-old nulliparous woman suspected of having ovarian cancer underwent exploratory laparotomy. During the operation, a 13-cm marked necrotic mass, occupying the lower pelvic cavity and with severe dense adhesion between the tumor and surrounding organs, was found. An extensive tumor excision was performed, but was complicated with rectal perforation, which subsequently required a temporary S- colostomy after complete excision of the tumor. The final pathology was actinomycosis. The patient was treated initially with intravenous penicillin G, followed by oral amoxicillin, and colostomy was repaired 6 months after the initial operation. Conclusions: Actinomycosis should be considered in the differential diagnosis of abdominal or pelvic malignancies in women who have used an intrauterine device for contraception. Although treatment usually consists of surgical resection of the affected area due to preoperative diagnostic difficulty, we suggest using a less invasive procedure, such as small piece-incision biopsy and an immediate frozen pathology to avoid the potential risk of overtreatment and unnecessary complications.

Keywords

• actinomycosis
• intrauterine device
• ovarian malignancy