WE5.11 Intra-abdominal actinomycosis - an indolent masquerader of malignancy

Abstract

IntroductionA 54 years old lady who presented with constitutional symptoms of lethargy, weight loss and asthenia. She had been extensively evaluated for a possible gynaecological malignancy but with no definitive outcome. The symptoms were persistent and a decision had to be made towards surgery in the present climate of the covid19 pandemic.MethodFollowing oncology multi disciplinary meeting outcome she was taken up for a total abdominal hysterectomy and bilateral salpingo-oophrectomy. She was noted to have an incidental finding of an extensive tumour infiltrating the liver, colon, anterior abdominal wall and the urinary bladder. A surgical resection with ileostomy was performed on suspicion of an underlying malignancy.ResultsThe histopathological diagnosis revealed a picture of actinomycosis which had evaded us previously. Following this she was treated with prolonged course of antibiotics and has recovered well, thus altering our entire management plan.ConclusionActinomycosis albeit rare is an interesting mimic of tumours. This case also delves into the on-table decision making when in doubt about cancer.