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Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review

INTRODUCTION: Actinomycosis is a rare subacute or chronic bacterial infection caused by Gram positive, anaerobic or microaerophilic bacilli. It is characterized by suppuration, abscess formation, tissue fibrosis, draining sinuses & rarely as a soft tissue mass mimicking a tumor. CASE REPORT: A 1...

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Autores principales: Akhtar, Murtaza, Zade, Manish P., Shahane, Pawan L., Bangde, Akshay P., Soitkar, Sagar M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643463/
https://www.ncbi.nlm.nih.gov/pubmed/26439419
http://dx.doi.org/10.1016/j.ijscr.2015.09.030
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author Akhtar, Murtaza
Zade, Manish P.
Shahane, Pawan L.
Bangde, Akshay P.
Soitkar, Sagar M.
author_facet Akhtar, Murtaza
Zade, Manish P.
Shahane, Pawan L.
Bangde, Akshay P.
Soitkar, Sagar M.
author_sort Akhtar, Murtaza
collection PubMed
description INTRODUCTION: Actinomycosis is a rare subacute or chronic bacterial infection caused by Gram positive, anaerobic or microaerophilic bacilli. It is characterized by suppuration, abscess formation, tissue fibrosis, draining sinuses & rarely as a soft tissue mass mimicking a tumor. CASE REPORT: A 16 year old boy sustained a trauma over right forehead & wound after which patient presented with swelling over right forehead which was excised and was histopathologically reported as angiomatous lesion. Patient presented with recurrent swelling with ulceration over the same site. CT scan showed soft tissue mass with periosteal reaction of right frontal bone. Wide local excision with removal of periosteum was carried out. Raw area was covered with rotational scalp flap. Histopathology of the excised specimen showed features of actinomycosis. DISCUSSION: Cutaneous actinomycosis presenting as pseudocarcinomatous or sarcomatous mass is rare. Trauma is a common preceding event which was observed in present case. Histopathological confirmation is mandatory with visualization of sulfur granules. It is managed by high dose IV antibiotics. Surgical resection is a useful adjuvant therapy specially in large, disfiguring masses not responding to medical treatment and where excisional biopsy is helpful in establishing the diagnosis surgical excision alone is not curative, post operative long term antibiotics are adjuvant therapy to avoid recurrence. CONCLUSION: Actinomycosis of scalp skin is a rare entity and tumor like presentation is still uncommon. Lesions not resolving with routine antibiotics therapy should be suspected clinically as actinomycosis and treated with high dose antibiotics as histopathology from small biopsy is unreliable.
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spelling pubmed-46434632015-12-08 Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review Akhtar, Murtaza Zade, Manish P. Shahane, Pawan L. Bangde, Akshay P. Soitkar, Sagar M. Int J Surg Case Rep Case Report INTRODUCTION: Actinomycosis is a rare subacute or chronic bacterial infection caused by Gram positive, anaerobic or microaerophilic bacilli. It is characterized by suppuration, abscess formation, tissue fibrosis, draining sinuses & rarely as a soft tissue mass mimicking a tumor. CASE REPORT: A 16 year old boy sustained a trauma over right forehead & wound after which patient presented with swelling over right forehead which was excised and was histopathologically reported as angiomatous lesion. Patient presented with recurrent swelling with ulceration over the same site. CT scan showed soft tissue mass with periosteal reaction of right frontal bone. Wide local excision with removal of periosteum was carried out. Raw area was covered with rotational scalp flap. Histopathology of the excised specimen showed features of actinomycosis. DISCUSSION: Cutaneous actinomycosis presenting as pseudocarcinomatous or sarcomatous mass is rare. Trauma is a common preceding event which was observed in present case. Histopathological confirmation is mandatory with visualization of sulfur granules. It is managed by high dose IV antibiotics. Surgical resection is a useful adjuvant therapy specially in large, disfiguring masses not responding to medical treatment and where excisional biopsy is helpful in establishing the diagnosis surgical excision alone is not curative, post operative long term antibiotics are adjuvant therapy to avoid recurrence. CONCLUSION: Actinomycosis of scalp skin is a rare entity and tumor like presentation is still uncommon. Lesions not resolving with routine antibiotics therapy should be suspected clinically as actinomycosis and treated with high dose antibiotics as histopathology from small biopsy is unreliable. Elsevier 2015-09-28 /pmc/articles/PMC4643463/ /pubmed/26439419 http://dx.doi.org/10.1016/j.ijscr.2015.09.030 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Akhtar, Murtaza
Zade, Manish P.
Shahane, Pawan L.
Bangde, Akshay P.
Soitkar, Sagar M.
Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review
title Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review
title_full Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review
title_fullStr Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review
title_full_unstemmed Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review
title_short Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review
title_sort scalp actinomycosis presenting as soft tissue tumour: a case report with literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643463/
https://www.ncbi.nlm.nih.gov/pubmed/26439419
http://dx.doi.org/10.1016/j.ijscr.2015.09.030
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