Sarcomaと考えられた腹部放線菌症の2例

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  • TWO CASES OF ABDOMINAL ACTIONMYCOSIS ORIGINALLY DIAGNOSED AS SARCOMA

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Actinomycosis is chronic suppurative granulomatous disease caused by a Actinomyces israeli. Actinomyces israeli is an anaerobic, gram-positive bacteria that forms part of the normal flor of the human mouth and gastrointestinal tract. Cervicofacial, thoracic, and abdominal actinomycosis are the three most common forms of the disease. Since the lesions of actinomycosis are characterized by the presence of firm indurated masses, it is difficult to differentiate abdominal actinomycosis from malignant tumors.<br> Two cases of abdominal actinomycosis that were initially diagnosed as sarcoma are reported.<br> Case 1: A 64-year-old woman was admitted to our hospital, complaining of a mass (9×23cm) in the umbilical region. A preoperative diagnosis of saroma of the abdominal wall was made by ultrasonography and CT.<br> Case 2: A 48-year-old man complained of a mass (10×12cm) in the right upper quadrant. A preoperative diagnosis of sarcoma of the great omentum was made by ultrasonography, CT, barium enema and angiography.<br> In both cases a mass composed of abdominal wall, great omentum and transverese colon was resected en block. The cut surface of specimens showed abscesses and histologic examination showed “sulfur granules.”<br> Both cases are expected to be cured by wide surgical excision of the involved tissues, without administration of penicillin.

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