Pelvic Actinomycosis Mimicking Pelvic Malignancy

Saramago, Sofia Modesto; Cominho, Joana Catarina; Proença, Sara Soares Marques; Conde, Pedro João Casado; Nunes, Filomena Maria Pinheiro

doi:10.1055/s-0039-1688462

Cited by 6 publications

(20 citation statements)

References 11 publications

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“…The common symptoms of pelvic actinomycosis include pelvic pain, abnormal uterine bleeding, a palpable mass, and symptoms related to bowel obstruction or obstructive uropathy. [ 6 ] No underlying disease was found in many cases by Dominguez and Antony[ 7 ] similar to our case. According to Mabeza and Macfarlane, imaging features are usually nonspecific and nondiagnostic in the early stages of infection and often similar to local inflammatory or neoplastic processes.…”

Section: Discussionsupporting

confidence: 87%

Actinomycosis of the cervix mimicking stage II cervical cancer

Inuganti¹,

Ramya²,

Vaddatti³

et al. 2022

Int J App Basic Med Res

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Actinomycosis is a chronic bacterial infection, characterized by suppurative and granulomatous inflammation. In humans, actinomycosis is most frequently caused by Actinomyces israelii . It is a normal commensal which becomes pathogenic upon any breach in the mucosa. We report the case of cervical actinomycosis in a 45-year-old female who had a mass per vagina for 2 years. There was no history of any intrauterine contraceptive device insertion. The radiological diagnosis was a neoplasm as the lesion is extending into the adjacent structures. Surgery was planned and a biopsy was taken which revealed Actinomyces . The patient was administered long-term penicillins and advised follow-up. Pelvic actinomycosis should be included in the differential diagnosis of pelvic masses. Even though actinomycosis can present as a large pelvic mass invading adjacent structures, it can be treated with medications and without any surgical intervention.

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Section: Discussionsupporting

confidence: 87%

Actinomycosis of the cervix mimicking stage II cervical cancer

Inuganti¹,

Ramya²,

Vaddatti³

et al. 2022

Int J App Basic Med Res

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“…In laboratory examination, a high level of WBC is noticed with anemia which been revealed in 70% of cases [6] , [8] . Ultrasonography and other radiologic examination show no specific or suggestive signs, they reveal mostly a solid or cystic mass with thickened wall mimicking ovarian malignancy [2] , [9] , [10] , [11] . The diagnosis is based on bacteriologic or pathologic examination [1] , [12] .…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis is based on bacteriologic or pathologic examination [1] , [12] . Bacteriologic culture must be in anaerobic environment with examination in Gram coloring what allows to spot gram positive bacillus [11] , [13] , [14] . Bacteriologic determination of this bacillus is so hard because of its sensibility to oxygen, it’s difficult and slow growth in culture and its association with other anaerobic germs.…”

Section: Discussionmentioning

confidence: 99%

Pelvic actinomycosis: A confusing diagnosis

Ferjaoui

Arfaoui

Khedhri

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Actinomycosis is a rare chronic and suppurative infection caused by anerobic Gram Positive bacteria: actinomyces. Pelvic location is extremely rare, usually associated with history of IUD contraception and doesn't have specific signs. Pelvic actinomycosis diagnosis may be confused with pelvic gynecologic malignancies or abscess. We present a retrospective and descriptive study of twelve patients with pelvic actinomycosis diagnosed and managed in our department from January 2000 to December 2011. Cases presentation The patients' mean age was 47 years. 75% of them had a history of IUD for a mean period of 8,44 years. Pelvic pain was the most common complaint. In four cases, pre-operative clinical presumption was tubo-ovarian abscess. Gynecologic malignancies were suspected in 8 patients. Pelvic actinomycosis management was based on surgery and long-term antibiotic. Clinical discussion Pelvic actinomycosis is an extremely rare chronic infection, presenting 3% of human actinomycosis. Common clinical presentations include vaginal discharge, tubo-ovarian abscess and pelvic tumors mimicking gynecologic malignancies. It is difficult to diagnose. Association with IUD history was recognized. Management is based on surgery and long-term antibiotic administration. Conclusion Pelvic actinomycosis is an extremely rare chronic infection. This entity is difficult to diagnose. Accurate diagnosis can reduce complications and unnecessary surgeries, and can preserve fertility.

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“…Indeed, it was often difficult to establish the diagnosis of PA because patients' clinical presentation was heterogeneous and non-specific. The invasive potential of the infection into adjacent organs and the possible increase of CA125 tumoral markers [18] cause frequent confusion with advanced-stage ovarian neoplasia [15,16,19]. In our study, some of our patients had first been referred to and cared for in a cancer center before the diagnosis was determined.…”

Section: Discussionmentioning

confidence: 99%

“…In over half of cases, bacteriological samples are negative, and thus do not point to an infectious cause [2]. In this context, the hypothesis of an advanced ovarian neoplasm is most often adopted without a histopathological analysis being done, as one is not recommended [15,16]. Extensive surgery of the oncological type is often performed, and the diagnosis is established a posteriori with reference to the definitive pathological results.…”

Section: Introductionmentioning

confidence: 99%

Added-Value of Endometrial Biopsy in the Diagnostic and Therapeutic Strategy for Pelvic Actinomycosis

Carrara

Hervy

Dabi

et al. 2020

JCM

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The particularity of pelvic actinomycosis lies in the difficulty of establishing the diagnosis prior to treatment. The objective of this retrospective bicentric study was to evaluate the pertinence and efficacy of the different diagnostic tools used pre-and post-treatment in a cohort of patients with pelvic actinomycosis. The following data were collected: clinical, paraclinical, type of treatment, and the outcome and pertinence of the two diagnostic methods, bacteriological or histopathological, were evaluated. Twenty-seven women were included, with a pre-treatment diagnosis proposed for 66.7% (n = 18) of them. The diagnosis was established in 13.6% (n = 3) of cases through bacteriological samples, and in 93.8% (n = 15) of cases through histopathological samples, with endometrial biopsy positive in 100% of cases. The treatment was surgical with antibiotics for 55.6% (n = 15) of patients, medical with antibiotic therapy for 40.7% (n = 11) of patients, and surgical without antibiotics for one patient. All patients achieved recovery without recurrence, with a median follow-up of 96 days (4-4339 days). Our study suggested an excellent performance of histopathological analysis, and in particular endometrial biopsy, in the diagnosis of pelvic actinomycosis. This tool allowed early diagnosis and, in some cases, the use of antibiotic therapy alone, making it possible to avoid surgery.

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Pelvic Actinomycosis Mimicking Pelvic Malignancy

Cited by 6 publications

References 11 publications

Actinomycosis of the cervix mimicking stage II cervical cancer

Actinomycosis of the cervix mimicking stage II cervical cancer

Pelvic actinomycosis: A confusing diagnosis

Added-Value of Endometrial Biopsy in the Diagnostic and Therapeutic Strategy for Pelvic Actinomycosis

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