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Erschienen in: European Surgery 1/2016

01.02.2016 | Case Report

Actinomycosis mimicking pancreatic neuroendocrine tumor. Case report and review of the literature

verfasst von: MD V. Beltrame, MD S. Blandamura, MD I. C. Spolverato, MD S. Merigliano, MD C. Sperti

Erschienen in: European Surgery | Ausgabe 1/2016

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Summary

Background

Abdominal actinomycosis is an uncommon subacute or chronic inflammatory disease due to a filamentous, gram-positive, anaerobic bacterium: Actinomyces israelii. The pathogen invades surrounding tissues, spreads by contiguity causing a suppurative and granulomatous inflammation with formation of abscess.

Methods

Case report: A 66-year-old asymptomatic woman with incidentally radiological finding of a pancreatic head solid mass. Approximately 35 years before, she underwent cholecystectomy and choledocotomy for gallstones of the biliary tract. Suspecting of a neuroendocrine tumor, the patient was enrolled to pancreaticoduodenectomy.

Results

Histologic examination revealed pancreatic actinomycosis. Foci of severe dysplasia of the pancreatic ductal epithelium were found, and bacteria referable to Actinomyces were isolated.

Conclusions

Pancreatic actinomycosis is extremely rare but it should be considered in the differential diagnosis with other pancreatic disease. In the literature, it was been reported that the abdominal location could be related to contamination by gallstone spillage during biliary surgery. Prognosis is excellent if actinomycosis is well treated; early diagnosis is mandatory but remains a challenge, and often is achieved only after surgery.
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Metadaten
Titel
Actinomycosis mimicking pancreatic neuroendocrine tumor. Case report and review of the literature
verfasst von
MD V. Beltrame
MD S. Blandamura
MD I. C. Spolverato
MD S. Merigliano
MD C. Sperti
Publikationsdatum
01.02.2016
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 1/2016
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-015-0364-2