Urogenit Tract Infect.  2016 Aug;11(2):73-75. 10.14777/uti.2016.11.2.73.

Renal Actinomycosis Initially Misdiagnosed as Renal Cell Carcinoma with Renal Vein Thrombosis

• Kim JW
• Jeong HK
• Park JJ
• Chae JY
• Park HS
• Moon DG
• Oh MM

• KMID: 2350761
• DOI: http://doi.org/10.14777/uti.2016.11.2.73

Abstract

This case report describes an uncommon case of renal actinomycosis in a 63-year-old man. The patient underwent radical nephrectomy for suspicious renal cell carcinoma with renal vein thrombosis and spinal metastasis. The postoperative diagnosis of renal and spinal actinomycosis was established in accordance with the results from histological examination. Three years after surgery, the patient did not show any symptoms of recurrence.

Keyword

Actinomycosis; Carcinoma, renal cell; Renal vein thrombus

MeSH Terms

Actinomycosis*
Carcinoma, Renal Cell*
Diagnosis
Humans
Middle Aged
Neoplasm Metastasis
Nephrectomy
Recurrence
Renal Veins*
Thrombosis*

Figure

• 

  Fig. 1. An abdomino-pelvic computed tomography scan showed two exophytic renal masses—1.5 cm and 3.7 cm in size (A, B)—with renal vein thrombosis (C, arrow). The masses showed unclear margins with possible direct invasion to the ascending colon (arrows of A, B). (D) A magnetic resonance imaging scan showed a 2-cm soft-tissue mass on the anterior portion of the L2 vertebral body with cortical disruption (arrow).

• 

  Fig. 2. A photomicrograph showed filamentous bacteria in a sulfur granule (Gomori methenamine-silver staining, ×400).

Reference

1.Mueller MC., Ihrler S., Degenhart C., Bogner JR. Abdominal actinomycosis. Infection. 2008. 36:191.

2.Das N., Lee J., Madden M., Elliot CS., Bateson P., Gilliland R. A rare case of abdominal actinomycosis presenting as an inflammatory pseudotumour. Int J Colorectal Dis. 2006. 21:483–4.

3.Lee IJ., Ha HK., Park CM., Kim JK., Kim JH., Kim TK, et al. Abdominopelvic actinomycosis involving the gastrointestinal tract: CT features. Radiology. 2001. 220:76–80.

4.Wagenlehner FM., Mohren B., Naber KG., Mannl HF. Abdominal actinomycosis. Clin Microbiol Infect. 2003. 9:881–5.

5.Chang DS., Jang WI., Jung JY., Chung S., Choi DE., Na KR, et al. Renal actinomycosis with concomitant renal vein thrombosis. Clin Nephrol. 2012. 77:156–60.

6.Hayashi M., Asakuma M., Tsunemi S., Inoue Y., Shimizu T., Komeda K, et al. Surgical treatment for abdominal actinomycosis: a report of two cases. World J Gastrointest Surg. 2010. 2:405–8.

7.Lin CD., Tai HC., Wang CC., Yu CT., Chang SJ., Hsieh CH, et al. Renal actinomycosis—an unusual cause of a renal abscess. Urol Sci. 2012. 23:129–32.

8.Acevedo F., Baudrand R., Letelier LM., Gaete P. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis. 2008. 12:358–62.