Kim Hee Seoung, Park Noh Hyun, Park Keoung Ah, Kang Soon Beom
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Gynecol Obstet Invest. 2007;64(2):95-9. doi: 10.1159/000100058. Epub 2007 Feb 21.
Pelvic actinomycosis in women most commonly occurs during ascending infections, usually associated with intrauterine devices (IUDs). However, secondary hepatic actinomycosis is very rare. A 47-year-old woman using IUDs for 18 years was referred under the impression of ovarian cancer. Further investigation revealed a hepatic tumor diagnosed as an inflammatory pseudotumor by fine needle aspiration biopsy, and a pelvic mass diagnosed as pelvic actinomycosis by sulfur granules in bilateral adnexa gained by an explorative laparotomy. Long-term therapy with high-dose intravenous penicillin and oral amoxicillin resulted in clinical and radiological improvement. The management of pelvic actinomycosis is based on a medical approach, although it sometimes requires surgical intervention. However, the necessity for surgical treatment is controversial in cases of secondary hepatic actinomycosis.
女性盆腔放线菌病最常见于上行性感染期间，通常与宫内节育器（IUD）有关。然而，继发性肝放线菌病非常罕见。一名使用宫内节育器18年的47岁女性因疑似卵巢癌前来就诊。进一步检查发现，通过细针穿刺活检诊断为炎性假瘤的肝脏肿瘤，以及通过剖腹探查在双侧附件中发现硫磺颗粒而诊断为盆腔放线菌病的盆腔肿块。大剂量静脉注射青霉素和口服阿莫西林的长期治疗导致临床和影像学改善。盆腔放线菌病的治疗以药物治疗为主，尽管有时需要手术干预。然而，继发性肝放线菌病病例的手术治疗必要性存在争议。
