A Case of Retroperitoneum Actinomycosis

Noda, Daichi; Satou, Naofumi; Tokura, Y.; Ogata, Toshirou; Igarashi, Kiyomi; Inoue, Akihiko; Honma, Manabu; Maehara, Yasunobu

doi:10.2974/kmj.57.311

Cited by 2 publications

(1 citation statement)

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“…All of these cases were unilateral. 8,[26][27][28][29][30] Moreover, actinomycosis usually shows homogeneous enhancement in CT scan. 31 The most likely causes for bilateral adrenal mass are metastatic disease, congenital adrenal hyperplasia, bilateral cortical adenomas and infiltrative disease.…”

Section: Discussionmentioning

confidence: 99%

Masking and misleading: concomitant actinomycosis and B-cell lymphoma – a case report and review of literature

Lim

Wong²,

Leong³

et al. 2018

Scott Med J

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We report a 72-year-old patient who presented with an ulcerated palatal mass, weight loss and adrenal insufficiency. Repeated biopsies from the mass revealed actinomycosis with no features of malignancy, while computed tomography scanning revealed a left maxillary sinus mass with invasive features and bilateral large adrenal masses. Blood and urine investigations showed adrenal insufficiency. The patient was treated as actinomycosis with adrenal involvement and was given intravenous penicillin and intravenous hydrocortisone. However, his condition did not improve and new signs appeared, that of left facial swelling and lymphadenopathy. A repeat biopsy of the palatal and adrenal masses revealed B-cell lymphoma. This case highlights the possibility that actinomycosis and lymphoma may share similar clinical presentations and may coexist. Either may mask and/or mimic the other, thus causing a delay in diagnosis. We describe the clinical progress and review the related literature. Interestingly, 9 out of the 12 reported cases of concomitant actinomycosis and malignancy (including this case) involve haematological malignancy. A high index of suspicion and treatment response reassessment is important in the management of either rare clinical entity.

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