Intrauterine Contraceptive Device-Related Actinomycosis Infection Presenting as Ovarian Cancer with Carcinomatosis

Lim, Dong-Jin; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Kim, Nam Kyu

doi:10.1089/sur.2013.005

Cited by 4 publications

(4 citation statements)

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“…Thus, the endometrium post-pregnancy is more vulnerable, accounting for approximately 90% of all IUAs, most often following natural childbirth, cesarean section, or abortion. In this study, we examined 121 cases of secondary infertility (86.4%), and only 19 cases of primary infertility (13.6%), suggesting that secondary infertility causes IUAs more often, in agreement with the findings of the previous study mentioned (9).…”

Section: Discussionsupporting

confidence: 90%

“…Intrauterine infections are also an important cause of IUAs (8). IUAs can also occur in patients with non-tuberculous endometritis and lacking a history of intrauterine surgery; in fact, Lim et al demonstrated that postpartum or post-surgical low estrogen levels affected the repair of the endometrium, leading to IUAs (9). Thus, the endometrium post-pregnancy is more vulnerable, accounting for approximately 90% of all IUAs, most often following natural childbirth, cesarean section, or abortion.…”

Section: Discussionmentioning

confidence: 99%

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Factors affecting pregnancy outcomes following the surgical removal of intrauterine adhesions and subsequent in vitro fertilization and embryo transfer

Wang

Xie

et al. 2019

Exp Ther Med

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This study aimed to investigate the clinical factors affecting pregnancy rates following the surgical removal of intrauterine adhesions (IUAs) and subsequent in vitro fertilization and embryo transfer (IVF-ET). We retrospectively evaluated case data from patients who had undergone hysteroscopic surgery to remove varying degrees of IUAs and who had subsequently received assisted reproductive treatments with IVF-ET (in all 140 cycles) at our hospital between January, 2011 and January, 2015. The patient data were divided into either the pregnancy or non-pregnancy groups based on the pregnancy outcomes, and a number of clinicopathological variables were compared these two groups, such as age, infertility (type and duration), the number of prior surgical treatments for and severity of IUAs, the baseline follicle-stimulating hormone/luteinizing hormone (FSH/LH) ratio and estradiol level, endometrial thickness on the day of human chorionic gonadotropin (hCG) administration, etc. We selected the variables with statistically significant differences to generate multivariate logistic regression and linear correlation analyses. We found that i) the mean endometrial thickness on the day of hCG administration was greater in the pregnancy group, and that the average gestational age was younger than that in the non-pregnancy group. The different age groups had significantly different pregnancy rates. The mean baseline FSH/LH ratio of the women in the pregnancy group was lower than that in the women in the non-pregnancy group. The number of embryos transferred in the pregnancy group was higher than that in the non-pregnancy group. However, the other variables exhibited similar values between these two groups. ii) Our multivariate logistic regression analyses revealed that age and endometrial thickness on the day of hCG administration had significant effects on the pregnancy outcome. The baseline FSH/LH ratio and the number of embryos transferred were similar between the groups. On the whole, age and endometrial thickness on the day of hCG administration are the most important predictors of pregnancy outcome in the patients undergoing IVF-ET following the surgical removal of IUAs. Importantly however, the identification of effective methods with which to improve the endometrial thickness and the ovarian response in patients with diminished ovarian reserves warrants further investigation in future research.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Factors affecting pregnancy outcomes following the surgical removal of intrauterine adhesions and subsequent in vitro fertilization and embryo transfer

Wang

Xie

et al. 2019

Exp Ther Med

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“…The second case corresponds to a tubo-ovarian localization, more frequently reported in the literature, especially in a patient Case study with prolonged IUD use associated with a long history of abdominal pain, anorexia, weight loss, and pelvic tumor mass. 9 In most reports, the diagnosis of pelvic actinomycosis occurs in women younger than 50 years old, 10 and only 10% of the cases are diagnosed before surgery. First, clinical manifestations are nonspecific, consisting of fever, leukocytosis, weight loss, fatigue, and abdominal pain.…”

Section: Dr Saez Perrottamentioning

confidence: 99%

Infection versus cancer: management of actinomyces mimicking cervical cancer or ovarian cancer

Odetto

Perrotta

Saadi

et al. 2020

International Journal of Gynecological Cancer

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“…The nonspecific findings complicate the differential diagnosis of abdominopelvic actinomycosis from other chronic diseases such as chronic granulomatous infection, inflammatory bowel disease, and pelvic inflammatory diseases. Furthermore, it often presents as a mass either clinically or radiologically, which is not easily distinguishable from malignancies [ 12 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Severe abdominopelvic actinomycosis with colon perforation and hepatic involvement mimicking advanced sigmoid colon cancer with hepatic metastasis: a case study

Song

2018

BMC Surg

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BackgroundActinomycosis is a rare chronic invasive disease caused by Actinomyces spp. Although abdominopelvic actinomycosis, which involves the colon and the pelvic organs extensively, has been frequently reported, abdominopelvic actinomycosis presenting with colon perforation and hepatic involvement concurrently has yet to be reported.Case presentationA 55-year-old woman presented at the emergency room with squeezing epigastric pain. Palpation of the abdomen revealed a hard mass with no acute peritoneal signs. Vital signs were normal range except for tachycardia. Initial laboratory testing revealed leukocytosis, anemia, elevated C-reactive protein (CRP), hypoalbuminemia; and normal AST/ALT and BUN/creatinine. CT scan of the abdomen-pelvis revealed a microperforations of the sigmoid colon, abscess in the left lower quadrant and hepatic lesion. Furthermore, there was a large infiltrating conglomerated mass invading the urinary bladder, left adnexa, sigmoid, left inguinal canal and left pelvic wall area. Ultrasound revealed an intra-uterine device (IUD). All these findings initially raised a suspicion of malignancy such as advanced cancer of the colon with liver metastasis. Despite the rarity of the disease, actinomycosis were not excluded because of the IUD found on ultrasound. Parenteral antibiotics and percutaneous drainage of abdomen abscess as well as fasting with total parental nutrition were prescribed for sigmoid perforation and abscess. After 10 days of conservative treatment, no remarkable change was detected in conglomerated mass invading pelvis. Furthermore, the finding of newly developed mechanical small bowel obstruction warranted surgery. Exploratory laparotomy was performed for the removal of perforated colon, obstructive small bowel and organs involved and postoperative histology confirmed a diagnosis of colonic actinomycosis. The patient made an uneventful recovery and was started on a 6-month course of penicillin.ConclusionsAbdominopelvic actinomycosis presenting with colon perforation and hepatic involvement is extremely rare; however, it is clinically similar to advanced colon cancer with liver metastasis, therefore, complicating the preoperative diagnosis. A diagnosis of abdominopelvic actinomycosis should be considered in patients with a history of IUD and chronic abdominal pain, along with an abdominal mass or cutaneous abscess. If surgery is indicated, preoperative empirical antibiotic therapy for actinomycosis and frozen biopsy during surgery may be considered.

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Intrauterine Contraceptive Device-Related Actinomycosis Infection Presenting as Ovarian Cancer with Carcinomatosis

Abstract: Surgeons and clinicians should be aware of this infectious disease because of its atypical symptoms and potential to mimic soft tissue tumors or malignant neoplasms.

Cited by 4 publications

References 11 publications

Factors affecting pregnancy outcomes following the surgical removal of intrauterine adhesions and subsequent in vitro fertilization and embryo transfer

Factors affecting pregnancy outcomes following the surgical removal of intrauterine adhesions and subsequent in vitro fertilization and embryo transfer

Infection versus cancer: management of actinomyces mimicking cervical cancer or ovarian cancer

Severe abdominopelvic actinomycosis with colon perforation and hepatic involvement mimicking advanced sigmoid colon cancer with hepatic metastasis: a case study

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