Mimicking uterine malignancy: Pelvic actinomycosis with giant uterine leiomyoma

Li, Changzai; Zhang, Pan; Jiao, Guimei; Lv, Jie; Ma, Chao; Song, Xudong; Zhang, Jinji; Wu, Chuntao; Li, Ruiwei; Zhu, Huiming

doi:10.1016/j.idcr.2020.e00878

Cited by 3 publications

(5 citation statements)

References 12 publications

(3 reference statements)

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“…While many cases of pelvic actinomycosis in women are associated with IUDs, representing 20% of actinomycosis cases reported, 3 this case highlights the overlooked etiology of actinomycosis due to diverticular disease. Actinomyces invasion due to a breach in colonic mucosa can lead to the development of complicated actinomycosis pelvic infection.…”

Section: Discussionmentioning

confidence: 80%

“…Given the vague presenting symptoms, often mimicking malignancy, it is estimated 10% are diagnosed pre-operatively. 3 Pre-operative diagnosis can avoid laparotomy and guide management with long-term antibiotics. In this case, laparotomy resulted in extensive resection and vascular injury necessitating 6 months anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of actinomycosis involves high-dose penicillin, recommended as intravenous therapy for 6 weeks and 12 months oral therapy to prevent recurrence. 3 This regimen depends on the lesion size, presenting symptoms, abscess or sinus tract formation requiring definitive surgery and previous failed medical therapy. 1 Without a pre-operative diagnosis, the lesion should be treated as a potential malignancy and excised by a surgical oncologist.…”

Section: Discussionmentioning

confidence: 99%

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Pelvic actinomycosis

Floyd

Hunter

Saadeh

et al. 2021

QJM: An International Journal of Medicine

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Background Actinomycosis is a rare infectious disease caused by Actinobacteria. It has a wide spectrum of presenting symptoms depending on anatomical location and can occasionally mimic pelvic malignancy and cause diagnostic difficulty. Case A female in her seventies presented with altered bowel habit, anorexia and abdominal discomfort with a history of diverticulosis. CT-AP revealed a sigmoid lesion causing large bowel obstruction. She underwent a laparoscopic defunctioning sigmoid loop colostomy and limited sigmoidoscopy. Subsequent endoscopy showed no dysplastic change but obvious stricturing. A diagnosis of locally perforated diverticular disease was made. Subsequent imaging showed rapid progression with hydroureter and hydronephrosis, now suggesting locally perforated sigmoid tumour or gynaecological malignancy. Tumour markers were normal. She underwent surgical exploration and resection. Specimen evaluation revealed Actinomyces likely originating from diverticular disease. Treatment involved long-term antibiotics for 12 months. Conclusion Pelvic Actinomyces is a difficult diagnosis to make on clinical and radiological findings. It should be considered in differential diagnoses of progressive pelvic lesions.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pelvic actinomycosis

Floyd

Hunter

Saadeh

et al. 2021

QJM: An International Journal of Medicine

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“…We also could not find any gynecological tumoral markers as part of the differential diagnosis of actinomycosis (such as CA-125, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), human chorionic gonadotropin (hCG), human epididymis protein 4 (HE4), etc.) considering the fact that actinomycosis can mimic neoplastic processes from a clinical and imagistic standpoint [65][66][67]. Despite their low specificity, their varying degrees of prognostic and predictive value, and the relatively low detection rate of early-stage malignancies, tumoral markers can be a useful tool for the appreciation of the progression of the disease.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Tubo-Ovarian Abscess with Actinomyces odontolyticus: Case Report and Brief Review of Literature

Pană

Neculicioiu

Țoc

et al. 2022

Reports

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Actinomyces odontolyticus is a strictly anaerobic species, a member of the Actinomyces genus and of the commensal flora, especially oral flora, which can trigger severe infections through breaches in healthy tissue or necrotic tissue that are often hard to diagnose clinically and microbiologically. Most infections with this species are pulmonary or pleural, which might hint at a connection with poor dental hygiene, but other locations have been documented. We present a case of a tubo-ovarian abscess with a difficult identification of the etiological agent in a woman with multiple admissions, no significant comorbidities, and a longstanding use of an IUD (intrauterine device). To our knowledge, no previous case of tubo-ovarian abscess with an accurate A. odontolyticus microbiological species identification has been reported so far. This case also highlights the importance of considering an anaerobic species as an etiologic agent in an infectious process concerning a previously damaged tissue and the importance of appropriate harvesting and culturing in the accurate diagnosis of such species.

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“…Croce et al hace énfasis en como el diagnóstico inicial puede realizarse por medio anatomopatológico, mediante el hallazgo de características benignas o malignas explicadas previamente (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Hay que recalcar que no siempre se cumplen estrictamente los criterios, en estos casos de incertidumbre se tiene que diagnosticar un STUMP como se menciono anteriormente y clasificarlo en cualquiera de sus subtipos (26,29).…”

Section: Introductionunclassified

Tumor de estirpe mesenquimal uterino: Presentación de caso clínico y revisión bibliográfica

Gavilanes Sáenz,

López Haro

2024

MedicienciasUTA

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Introducción: Los tumores mesenquimales uterinos son relativamente frecuentes, se clasifican ampliamente en leiomiomas, leiomiosarcomas y tumores de músculo liso de potencial maligno incierto (STUMP). Su clínica es inespecífica y en ciertos casos debido a la dificultad en su diagnóstico se necesitan estudios especiales para ser clasificados como totalmente benignos o malignos. Objetivo: Describir el caso clínico de una paciente con tumor mesenquimal uterino realizando una revision adecuada y actualizada de la bibliografía. Materiales y métodos: Estudio descriptivo retrospectivo, mediante la presentación de un caso clínico. Previamente se obtuvo el consentimiento informado de la paciente, se realizó una revisión sistemática de información científica en los buscadores bibliográficos PubMed, Scopus, Nature Portafolio, Springer Link y Scielo. Resultados: Paciente de 50 años que consultó por distención abdominal y dolor abdominal difuso de aproximadamente 3 meses de evolución. Ecográficamente se visualizó una masa de contenido heterogéneo que impresiona originarse en ovarios con volumen de 4575 cc, la misma que se confirmó por tomografía axial computarizada, posteriormente se decide laparotomía exploratoria encontrando masa abdominopélvica dependiente de cuerno uterino izquierdo que impresiona mioma subseroso gigante con adherencias y abundante neovascularización a mesenterio por lo que se realiza histerectomía más anexectomía, se envía para estudio histopatológico que reveló neoplasia de estirpe mesenquimal sin especificar diagnóstico de benignidad o malignidad por lo que se solicita estudio inmunohistoquímico para clasificarlo. Conclusiones: A pesar de que la intervención quirúrgica constituye una medida inicial en el tratamiento ante la sospecha de tumor mesenquimal, resulta imperativo validar el diagnóstico mediante análisis histopatológico, inmunohistoquímico y, en algunos casos, mediante evaluación de la genética molecular. Este enfoque se realiza con el propósito de discernir entre una lesión maligna o benigna, permitiendo así la implementación de un protocolo de manejo y seguimiento apropiado

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Mimicking uterine malignancy: Pelvic actinomycosis with giant uterine leiomyoma

Cited by 3 publications

References 12 publications

Pelvic actinomycosis

Pelvic actinomycosis

Tubo-Ovarian Abscess with Actinomyces odontolyticus: Case Report and Brief Review of Literature

Tumor de estirpe mesenquimal uterino: Presentación de caso clínico y revisión bibliográfica

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