Pelvic pseudotumoral actinomycosis: two cases

Pelvic actinomycosis is a rare suppurative disease that should be included in the differential diagnosis of gynecological cancers. We report two women aged 40 and 41 years with pelvic tumor-like actinomycosis. Physical examination disclosed a pelvic mass in both cases. CT-scan showed annexial infiltrative tumor in both cases with liver metastasis and peritoneal carcinosis in one case each. Surgical procedure consisted in right annexectomy in one case and peritoneal biopsy in the other. Pathologic diagnosis was diagnostic of actinomycosis. Both patients were treated by penicillin G 20 million IU/day during two weeks and then by amoxicilline 3g/day per day during six months. Clinical outcome showed significant improvement in both cases with complete regression of hepatic and pelvic lesions on CT-scan in one case. Pelvic actinomycosis is a rare suppurative disorder, commonly associated with a long term wearing of intra-uterine device. Diagnosis is difficult, often delayed and pelvic actinomycosis could mimic gynaecologic neoplasia.