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Appendiceal actinomycosis mimicking malignant tumor: a rare case report. | LitMetric

AI Article Synopsis

  • - Actinomycosis is a rare bacterial infection that often shows up as a mass on imaging, typically affecting the cervicofacial area, but can also occur in the abdomen, leading to misdiagnosis as a tumor in over 90% of cases until surgery.
  • - A 53-year-old woman with diabetes was initially suspected to have a malignant appendiceal tumor after imaging showed abnormality, but further tests and biopsy revealed it was actually actinomycosis.
  • - It’s important to remember that chronic appendicitis or abdominal masses can sometimes indicate actinomycosis; recognizing this can help avoid unnecessary surgeries for what might appear to be cancerous conditions.

Article Abstract

Introduction: Actinomycosis is an uncommon bacterial infection caused by bacteria that typically progresses slowly and leads to the formation of masses. Although it commonly affects the cervicofacial area, about 20% of cases occur in the abdominopelvic region. Because the disease can be mistaken for a tumour due to its infiltrative mass-like nature on imaging, over 90% of cases are only diagnosed following surgery and histological confirmation. This report describes a case of an appendicular mass, initially suspected to be a malignant tumour, but eventually diagnosed as appendiceal actinomycosis.

Presentation Of Case: Upon initial presentation, a 53-year-old woman with type II diabetes mellitus and no prior surgical history, displayed abnormal appendiceal uptake during a PET-computed tomography (CT) scan conducted for a suspected spinal tumour. Colonoscopy did not indicate any notable observations, and the patient chose to defer immediate action. Several months later, a CT scan revealed an increased mass-like appearance of the appendix compared to the previous PET-CT scan. After multidisciplinary discussions, a right laparoscopic hemicolectomy was recommended due to suspected malignancy. However, histological staining on microscopy confirmed actinomycosis originating from the appendix.

Discussion: Chronic appendicitis with radiologic features similar to appendiceal carcinoma, or abdominal masses located in the ileocecal area, in patients with or without a previous surgical history should raise suspicion of actinomycosis.

Conclusion: Appendiceal actinomycosis should be considered in the differential diagnosis in the aetiology of chronic appendicitis mimicking appendiceal carcinoma. Awareness and accurate diagnosis of appendiceal actinomycosis can prevent unnecessary extended surgery as was performed in this case.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849298PMC
http://dx.doi.org/10.1097/MS9.0000000000001564DOI Listing

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