Actinomycosis Mimicking Gynecological Malignancy: Imaging Patterns in Seven Cases
Pelvic actinomycosis is uncommon and believed to be related to the use of intrauterine devices (IUDs). It may present as a complex gynecological mass either uterine or adnexal with or without local pelvic spread or with peritoneal dissemination, all features which mimic gynecological malignancy. We describe seven women with proven actinomycosis who presented to a single cancer center gynecological cancer multidisciplinary team meeting (MDTM) to illustrate these imaging appearances and highlight discriminant features of actinomycosis. A minority of women had concurrent use of an IUD. Involvement of the pararectal space was a feature of pelvic disease extension. We describe the value of image-guided core biopsy (IGCB) in confirming the diagnosis.