Pelvic actinomycosis masquerading as sarcoma in a hysterectomized woman: A comprehensive case study

Document Type : Case Report

Authors

1 Department of Nuclear Medicine, Eastern Command Hospital, Kolkata, India

2 Department of Obstetrics and Gynecology, Eastern Command Hospital, Kolkata, India

3 Department of Nuclear Medicine, Central Command Hospital, Lucknow, India

4 Department of Pathology, Eastern Command Hospital, Kolkata, India

Abstract

Pelvic actinomycosis, a chronic and invasive condition caused by Actinomyces spp., often mimics malignancies, creating diagnostic challenges. This report details the case of a hysterectomized woman presenting with vaginal bleeding, intense pelvic pain, constipation, and weight loss. Initial assessments suggested sarcoma due to a firm, fixed mass in the right pelvis with vaginal infiltration. Imaging techniques, such as contrast-enhanced Computerized Tomography (CECT) of the abdomen and pelvis, and [18F]FDG Positron Emission Tomography Computed Tomography (PET/CT scan), confirmed a solid cystic pelvic mass infiltrating surrounding structures. Cystoscopy showed bladder mucosa infiltration; however, biopsies were inconclusive for malignancy but indicated actinomycosis. Treatment with oral Penicillin G significantly alleviated pain, restored bowel function, and led to weight gain, along with radiological improvements.

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References

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