A palpable tumour was discovered in the left lower abdomen of a 66-year-old woman with uncharacteristic lower-abdominal pain and treatment-resistant pollakisuria and stress incontinence. On ultrasound examination the tumour was about 6.0 x 2.5 x 2.5 cm in size and was located between bladder roof and anterior abdominal wall. Ultrasound-guided fine-needle biopsy failed to produce any cytologically interpretable material, and there was no bacterial growth from the aspirate. All clinical and biochemical findings were normal, except for a raised blood-sedimentation rate (15/43 mm). The tumour, completely removed at laparotomy, was diagnosed to be actinomycosis of the bladder. No long-term postoperative antibiotic treatment was undertaken. Nine months after the operation the patient was without symptoms and there were no abnormal clinical findings.
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