Actinomycosis in urachal remnants: A rare cause of pseudotumor

Actinomycosis is a chronic inflammatory condition caused by Actinomyces israeli, a gram positive anaerobic bacterium. It can have a variety of clinical manifestations and can mimic a malignancy. We present one such case of urachal actinomycosis that mimicked a tumor. A 28-year-old man presented with...

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Main Authors: V Chaitra, T Rajalakshmi, Suravi Mohanty, N K Lahoti, Arun George, Jyothi Idiculla
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2011-01-01
Series:Indian Journal of Urology
Subjects:
Online Access:http://www.indianjurol.com/article.asp?issn=0970-1591;year=2011;volume=27;issue=4;spage=545;epage=546;aulast=Chaitra
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author V Chaitra
T Rajalakshmi
Suravi Mohanty
N K Lahoti
Arun George
Jyothi Idiculla
author_facet V Chaitra
T Rajalakshmi
Suravi Mohanty
N K Lahoti
Arun George
Jyothi Idiculla
author_sort V Chaitra
collection DOAJ
description Actinomycosis is a chronic inflammatory condition caused by Actinomyces israeli, a gram positive anaerobic bacterium. It can have a variety of clinical manifestations and can mimic a malignancy. We present one such case of urachal actinomycosis that mimicked a tumor. A 28-year-old man presented with abdominal pain of 20 days duration. Per abdominal palpation revealed a firm mass with ill-defined borders in the suprapubic region. Computed tomography and magnetic resonance imaging scans of the pelvis showed an irregular lesion in the urinary bladder extending to the umbilicus, giving the impression of urachal remnants with inflammation. Peroperatively, an irregular, hard mass measuring 6 x 5 cm, involving the anterior and posterior bladder walls, the appendix, the terminal ileum and sigmoid colon, was seen, which was suspicious for a malignancy. Frozen sections from the mass showed extensive inflammation and a florid fibroblastic proliferation, giving the impression of an inflammatory pseudotumor. The tissue was extensively sampled for paraffin sections and only one of them revealed a colony of Gram, PAS and GMS- positive organisms, conclusive for Actinomycosis. It is important to be aware of this uncommon, yet significant, presentation of a common infectious disease in order to avoid misdiagnosis and over-treatment as a malignancy.
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spelling doaj.art-bca988c60fe045918647164d9adbd22f2022-12-21T18:45:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242011-01-0127454554610.4103/0970-1591.91450Actinomycosis in urachal remnants: A rare cause of pseudotumorV ChaitraT RajalakshmiSuravi MohantyN K LahotiArun GeorgeJyothi IdicullaActinomycosis is a chronic inflammatory condition caused by Actinomyces israeli, a gram positive anaerobic bacterium. It can have a variety of clinical manifestations and can mimic a malignancy. We present one such case of urachal actinomycosis that mimicked a tumor. A 28-year-old man presented with abdominal pain of 20 days duration. Per abdominal palpation revealed a firm mass with ill-defined borders in the suprapubic region. Computed tomography and magnetic resonance imaging scans of the pelvis showed an irregular lesion in the urinary bladder extending to the umbilicus, giving the impression of urachal remnants with inflammation. Peroperatively, an irregular, hard mass measuring 6 x 5 cm, involving the anterior and posterior bladder walls, the appendix, the terminal ileum and sigmoid colon, was seen, which was suspicious for a malignancy. Frozen sections from the mass showed extensive inflammation and a florid fibroblastic proliferation, giving the impression of an inflammatory pseudotumor. The tissue was extensively sampled for paraffin sections and only one of them revealed a colony of Gram, PAS and GMS- positive organisms, conclusive for Actinomycosis. It is important to be aware of this uncommon, yet significant, presentation of a common infectious disease in order to avoid misdiagnosis and over-treatment as a malignancy.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2011;volume=27;issue=4;spage=545;epage=546;aulast=ChaitraActinomycosispseudotumorurachal remnants
spellingShingle V Chaitra
T Rajalakshmi
Suravi Mohanty
N K Lahoti
Arun George
Jyothi Idiculla
Actinomycosis in urachal remnants: A rare cause of pseudotumor
Indian Journal of Urology
Actinomycosis
pseudotumor
urachal remnants
title Actinomycosis in urachal remnants: A rare cause of pseudotumor
title_full Actinomycosis in urachal remnants: A rare cause of pseudotumor
title_fullStr Actinomycosis in urachal remnants: A rare cause of pseudotumor
title_full_unstemmed Actinomycosis in urachal remnants: A rare cause of pseudotumor
title_short Actinomycosis in urachal remnants: A rare cause of pseudotumor
title_sort actinomycosis in urachal remnants a rare cause of pseudotumor
topic Actinomycosis
pseudotumor
urachal remnants
url http://www.indianjurol.com/article.asp?issn=0970-1591;year=2011;volume=27;issue=4;spage=545;epage=546;aulast=Chaitra
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AT trajalakshmi actinomycosisinurachalremnantsararecauseofpseudotumor
AT suravimohanty actinomycosisinurachalremnantsararecauseofpseudotumor
AT nklahoti actinomycosisinurachalremnantsararecauseofpseudotumor
AT arungeorge actinomycosisinurachalremnantsararecauseofpseudotumor
AT jyothiidiculla actinomycosisinurachalremnantsararecauseofpseudotumor