Retroperitoneal Actinomycosis Mimicking a Malignant Neoplasm of Adrenal Gland

Abstract

Actinomycosis is a chronic disease characterized by abscess formation, tissue fibrosis, and draining sinuses. In this study, we aimed to present the clinical and radiological findings of a rare pathology, retroperitoneal actinomycosis case mimicking adrenal tumor and review the literature. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with poor dental hygiene), but also that actinomycosis may mimic the malignancy process in various anatomical sites. Actinomycosis manifests as tumor-like lesions mainly in the cranio-cervical region (60-80%), thorax (1015%), abdomen (5-20%) and exceptionally in retroperitoneal organs. Positron emission tomography (PET) revealed hypermetabolic mass lesion 63 × 52 × 73 mm in size on the left adrenal gland showed a standardized uptake value (SUV) of 18.2. The patient underwent left adrenalectomy. The pathologic examination revealed actinomycosis. The patient was treated with antibiotics.