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Actinomycosis of the omentum with invasion of the abdominal wall, small bowel and transverse colon mimicking malignancy
  1. Edward Caplan,
  2. Mohammed Deputy,
  3. Dhili Arul and
  4. Jonathan Wilson
  1. General Surgery, Whittington Health NHS Trust, London, United Kingdom
  1. Correspondence to Dr Edward Caplan, TMCaplan{at}


We report the case of a 59-year-old Russian man who presented with a painless, slow-growing, epigastric mass. CT revealed a large heterogeneous mass within the omentum infiltrating into adjacent tissues. During diagnostic laparoscopy, the omental mass was noted to be firm, raising the suspicion of malignancy. Surgical en-bloc resection of the mass, including the posterior rectus sheath, transverse colon and small bowel, was performed with primary anastomoses at laparotomy. Histological examination was inconsistent with malignancy and revealed the mass to be actinomycosis, confirmed by microscopy and gram staining. Surgical resection was followed by an 8-week course of penicillin and doxycycline antibiotic therapy. This treatment resulted in full clinical and radiological recovery with no complications. Although the clinical and radiological findings, in this case, were highly suspicious of malignancy, abdominal actinomycosis should be considered a differential diagnosis in patients with infiltrative abdominal masses and mild constitutional symptoms.

  • gastrointestinal surgery
  • infectious diseases
  • colon cancer

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  • Contributors EC: conception of the project, drafted the case report, revised it with the other authors and approved the final article version prior to submission. MD and JW: conception of the project, revised the article critically and approved the final article version prior to submission. AD: acquisition and interpretation of figures used in the project, revised the article and approved the final version prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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