Abstract
Actinomycosis is a chronic suppurative infection, for which immune suppression is a predisposing factor. In unusual cases, this disease may present as an abdominal wall involvement simulating a soft tissue tumor as seen in the present case. The presented patient had no signs of trauma or surgical approach and the pathology was considered to be a primary abdominal wall actinomycosis. Preoperative diagnosis is difficult due to the nonspecific nature of clinical presentation, radiographic and laboratory findings. Surgery combined with antibiotic treatment is a curative approach for this relatively rare infection. Surgeons must be aware of this disease in order to ensure correct diagnosis and to prevent performing any unnecessary procedures. The present study describes a case of abdominal actinomycosis with multiple myeloma, together with a review of important points related to this disease.
Highlights
Actinomycosis is a chronic suppurative granulomatous infection characterized by abscess and fistula formation, and caused by aerobic or microaerophilic bacteria [1,2]
Injury to the mucosal barrier is of critical importance to the pathogenesis of the disease [1], since this is the primary entrance for actinomycosis to invade [4]
The current study presents a case of primary abdominal wall actinomycosis in a Correspondence to: Dr Vehbi Ercolak, Department of Medical Oncology, Faculty of Medicine, Harran University, Necmettin Cevheri Street, Yenişehir, Sanliurfa 63300, Turkey E-mail: vehbiercolak@hotmail.com
Summary
63‐year‐old male with multiple myeloma, as well as a review of the literature. A 63‐year‐old male was admitted to the Department of Medical Oncology of the Medical Faculty of Çukurova University (Adana, Turkey) with abdominal pain and weight loss (10 kg) for two months. The patient had been diagnosed with multiple myeloma and had been treated by three cycles of vincristine, doxorubicin and dexamethasone plus zoledronic acid. A suprapubic mass (3 cm diameter) was found by physical examination, and computerized tomographic scans showed a cystic mass on the rectus abdominis muscle. Repeated fine needle aspirations were non‐diagnostic and a biopsy showed fibro‐adipous tissue. An excision of the mass was performed under general anesthesia, and a mass biopsy was reported as an active chronic suppurative infection and actinomycosis Following the treatment of actinomycosis, bortezomib treatment was started for multiple myeloma
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