Pelvic actinomycosis with tuboovarian invelvement mimicking ovarian neoplasm: Case report

Yıl 2010, Cilt: 41 Sayı: 4, 217 - 0, 01.05.2010

YILDIRIM Nilsen Erdoğan Yalçın Erdoğan Onur Başaran

Öz

Actinomycosis is a chronic, suppurative, granulomatous bacterial infection caused by Actinomyces Israeli with rarely involment of pelvis. However, it is a clinical entity that its relationship with the conditions of facilitated access of microorganisms to pelvis such as intrauterine devices, well-defined. It can be diagnosed before they becoming symptomatic, with the seeing actinomyces-like organisms in routine Pap smear screening of intrauterine device users. But, in patients who have not these screenings, it often appears with of pelvic inflammatory disease clinic. In this report, a pelvic actinomycosis case which showed involvement of tuba-ovarian localization and was determined with histopathological examination in a 27 years old patient, who was operated with the prediagnosis of an ovarian mass, is presented.

Anahtar Kelimeler

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Over tümörünü taklit eden Tuba-ovaryan yerleşimli pelvik aktinomikozis: Olgu sunumu

Öz

Aktinomikozis, Actinomyces Israeli 'nin neden olduğu kronik, süpüratif, granülomatöz, pelvik tutulumun nadir olduğu bakteriyel bir enfeksiyondur. Ancak rahim içi araç gibi mikroorganizmaların pelvise ulaşımının kolaylaştığı durumlarla ilişkisi iyi tanımlanmış klinik bir antitedir. Rahim içi araç kullananların rutin Pap smear taramalarında Aktinomiçes benzeri mikroorganizmaların görülmesi ile semptomatik hale gelmeden tanısı konulabilir. Ancak, bu taramaları yaptırmayan hastalarda sıklıkla pelvik inflamatuar hastalık kliniği ile karşımıza çıkar. Bu çalışmada 27yaşında 'ovarian kitle'ön tanısı ile öpere edilen hastada yapılan histopatolojik inceleme ile saptanmış olan tuba-ovarian lokalizasyonda tutulum gösteren pelvik aktinomikoz olgusu sunulmaktadır.

Anahtar Kelimeler

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Kaynakça

• 1- Lee YK, Bae JM, Park YJ, Park SY, Jung SY. Pelvic actinomycosis with hydronephrosis and colon stricture simulating an advanced ovarian cancer. J Gynecol Oncol. 2008,19(2): 154-6
• 2- McLeod R, Smith S, Poore TE, Lindsey JL, Remington JS. Tubo-ovarian Actinomycosis and the Use of Intrauterine Devices. West J Med. 1980,132(6): 531-5
• 3- Valko P, Busolini E, Donati N, Chimchila Chevili S, Rusça T, Bernasconi E. Severe large bowel obstruction secondary to infection with Actinomyces israelii. Scand J Infect Dis. 2006;38(3): 231-4
• 4- Biyani DK, Denley H, Hill J, Watson AJ. IUCD induced abdomino-pelvic actinomycosis presenting as acute large bowel obstruction. J Obstet Gynaecol. 2007;27(8): 870-1
• 5- Iwasaki M, Nishikawa A, Akutagawa N, Fujimoto T, Teramoto M, Kudo R. A case of ovarian actinomycosis. Infect Dis Obstet Gynecol. 2003; 11(3): 171-3
• 6- Harmouch T, Znati K, Elfatemi H, Chbani L, Bennis S, Amarti A. Solid pseudotumoral tubo-ovarian actinomycosis. A case report in Morocco. MedTrop (Mars).2008;68(3): 287-9
• 7- Thamban S, Khan R, Dawlatly B. Surgical management of chronic tubo-ovarian actinomycosis simulating malignancy: a case report. J Obstet Gynaecol. 2005;25(4):408
• 8- Marwah S, Marwah N, Singh I, Singh S, Gupta A, Jaiswal TS. Ovarian actinomycosis in absence of intrauterine contraceptive device: an unusual presentation. Acta Obstet Gynecol Scand. 2005,84(6): 602-3
• 9- Hwang JH, Hong JH, Lee JK. Ovarian and vesical actinomycosis: a case report and literature review. Arch Gynecol Obstet. 2009 ;279(4): 591-3
• 10- Efthimiou I, Mamoulakis C, PetrakiK, Zorzos I. Renal actinomycosis presenting as a suppurated solitary cyst. Indian J Urol. 2008 ;24(3): 416-8
• 11- Dieckmann KP, Henke RP, OvenbeckR. Renal actinomycosis mimicking renal carcinoma. Eur Urol. 2001,39(3): 357-9
• 12 - Habek D, Has B, Habek JC. Tuboovarian abscess mimicking intraligamentar uterine myoma and a intrauterine device: a case report. Eur J Contracept Reprod Health Care. 2005; 10(3): 168-70
• 13- Dharmadhikari D, Dharmadhikari R, Macdonald J, Beukenholdt R. Intrauterine contraceptive device-related actinomycosis infection presenting as an incarcerated inguinal hernia. J Obstet Gynaecol Res. 2007;33(4): 595-7
• 14- Sergent F, Marpeau L. Comment on the article entitled by S. Abdelmoula-Marzouki et al.: Tuboovarian actinomycosis ruptured into the sigmoid colon. Ann chir2003; 128: 719-721) Ann Chir. 2004,129(3): 183-4
• 15- Koshiyama M, Yoshida M, Fujii H, Nanno H, Hayashi M, Tauchi K, Kaji Y. Ovarian actinomycosis complicated by diabetes mellitus simulating an advanced ovarian carcinoma. Eur J Obstet Gynecol Reprod Biol. 1999;87(1): 95-9
• 16- Schmidt WA. IUDs, inflammation, and infection: assessment after two decades of IUD use. Hum Pathol. 1982,-13(10): 878-81
• 17- Hager WD, Douglas B, Majmudar B, Naib ZM, Williams OJ, Ramsey C, Thomas J. Pelvic colonization with Actinomyces in women using intrauterine contraceptive devices. Am J Obstet Gynecol. 1979,135(5): 680-4
• 18- Tedeschi A, Di Mezza G, D'Amico O, Ermann A, Montone L, Siciliano M, Cobellis G. A case of pelvic actinomycosis presenting as cutaneousfistula. Eur J Obstet Gynecol Reprod Biol. 2003; 108(1): 103-5