Abdominal Actinomycosis misdiagnosed as liposarcoma
Keywords:Abdominal actinomycosis, liposarcoma, challenging diagnosis
Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula’s tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient’s full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.
How to Cite
Copyright and publishing license
Authors retain copyright granting the journal right of first publication with the work simultaneously licensed under the Creative Commons Attribution Non-Commercial License.
Autopsy and Case Reports accepted articles are published under the Creative Commons Attribution Non-Commercial License. Under this License, the authors agree to have the CC-BY-NC license applied to their work, which retains the author's ownership of the copyright for their article and permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original authors and source are properly cited. This facilitates freedom in re-use and also ensures that the journal's content can be mined without barriers for the needs of research.