# Ovarian Actinomycosis Mimicking Ovarian Malignancy: A Case Report

## TL;DR

A rare case of ovarian actinomycosis is reported, which can resemble ovarian cancer and may be linked to long-term IUD use.

## Contribution

This case report highlights ovarian actinomycosis as a rare but important differential diagnosis in IUD users with suspicious ovarian masses.

## Key findings

- Ovarian actinomycosis can mimic ovarian malignancy, leading to diagnostic challenges.
- Long-term intrauterine device use is a potential risk factor for this condition.
- Early diagnosis through histopathology can prevent unnecessary surgical interventions.

## Abstract

Actinomyces spp. are non-spore-forming anaerobic bacteria that can be part of the normal flora of human oral, intestinal, and urogenital tracts. Mucosal disruption can lead to an infection characterized by granulomatous inflammation leading to abscess formation and sinus tracts classically draining pus with sulfur granules. Most actinomycosis cases are polymicrobial, involving various aerobic and non-aerobic bacteria. Cervicofacial actinomycosis is by far the most common, accounting for more than half of its presentations; however, cases of thoracic, abdominal, pelvic, and central nervous system (CNS) actinomycosis have also been described in the literature. Due to its non-specific symptoms, actinomycosis can mimic various conditions, including malignancies, Crohn’s disease, and tuberculosis. The diagnosis usually becomes clear after histopathologic examination. We would like to present a case of ovarian actinomycosis, a rare condition that has been associated with long-term intrauterine device (IUD) users and may mimic ovarian malignancy. Recognizing the patients at risk and using ancillary diagnostic testing may lead to early diagnoses and better outcomes for patients, including avoiding unnecessary surgery.