Endocrinol Metab.  2010 Jun;25(2):147-151. 10.3803/EnM.2010.25.2.147.

A Case of Adrenal Actinomycosis that Mimicked a Huge Adrenal Tumor

• Kim EJ
• Yi HS
• Yo I
• Park S
• Kim KM
• Park YS
• Lee S
• Kim YS
• Park IB

• KMID: 2169022
• DOI: http://doi.org/10.3803/EnM.2010.25.2.147

Abstract

The incidence of adrenal incidentalomas has increased because imaging studies are now being more frequently performed, including abdominal sonography, CT and MRI. Although there is only a consensus on the treatment of adrenal incidentalomas from the National Institute of Health (NIH) conference 2003, it is generally accepted that surgical resection is required if there's any possibility of malignancy or functionality of the adrenal tumor. Abdominopelvic actinomycosis is a rare chronic progressive suppurative disease that is caused by gram-positive bacteria of the genus actinomyces, which is part of the normal flora of the oral cavity and gastrointestinal tract, with low virulence. Herein, we report on a case of adrenal actinomycosis that imitated a huge adrenal tumor in a 39-year-old women, and the adrenal actinomycosis was confirmed histologically only after adrenalectomy. To the best of our knowledge, this is the first Korean case report on actinomycosis that occurred in the adrenal gland.

Keyword

Actinomycosis; Adrenal glands; Incidentaloma

MeSH Terms

Actinomyces
Actinomycosis
Adrenal Glands
Adrenalectomy
Adult
Consensus
Female
Gastrointestinal Tract
Gram-Positive Bacteria
Humans
Incidence
Mouth

Figure

• 

  Fig. 1 CT scan shows about 4 × 2.3 cm-sized heterogeneous enhancing mass at the arterial phase and delayed phase including the early wash-out lesion (arrow) in the center of mass corresponding to bleeding portion on left side adrenal gland.

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  Fig. 2 A. There is a 5.7 × 2.8 cm-sized adrenal gland. The cut surface is light grey in color and necrotic in cortical area. Medullary lesion shows fibrosis. B. Photomicrograph shows actinomycotic abscesses containing sulfur granules with radiating filaments (H&E stain, × 200).

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  Fig. 3 Fever status and antibiotics coverage.

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