Juan A. Villanueva-Herrero, Unidad de Fisiología Anorrectal, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Carolina Enríquez-Cabrera, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Carlos A. López-Bernal, Unidad de Fisiología Anorrectal, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Gisela G. Oropeza-Rodríguez, Unidad de Fisiología Anorrectal del Servicio de Coloproctología, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México, México
Luis A. Téllez-Baca, Unidad de Fisiología Anorrectal, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Lisbeth Alarcón-Bernes, Servicio de Cirugía General, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Francisco Godínez-Olmos, Cirugía General, Hospital de Especialidades Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS), Pue., México
Bruno Salinas-Cabrera, Cirugía General, Hospital de Especialidades Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS), Pue., México
Eduardo Nava-Carmona, Cirugía General, Hospital de Especialidades Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS), Pue., México
José G. Gutiérrez-Durante, Servicio de Coloproctología, Hospital de Especialidades Manuel Ávila Camacho, IMSS, Pue., México
Jeziel K. Ordoñez-Juárez, Unidad de Fisiología Anorrectal del Servicio de Coloproctología, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México, México
Billy Jiménez-Bobadilla, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Objective: Report the clinical, radiological, and histopathological features of a case series of four patients with abdominal actinomycosis mimicking colon cancer, and to analyze the surgical management associated with this entity. Methods: A retrospective study of four patients with histopathologically confirmed abdominal actinomycosis whose clinical and imaging presentation simulated colonic malignancy. Demographic variables, clinical presentation, imaging findings, endoscopic features, histopathology, surgical treatment, and outcomes were analyzed. A narrative review of the relevant published literature was additionally analyzed. Results: Two women and two men, aged 42 to 60 years, were included. Predominant symptoms were abdominal pain, weight loss, and a palpable abdominal mass. Predisposing factors were identified in two patients: prolonged intrauterine device use and diabetes mellitus. Computed tomography demonstrated infiltrative masses with colonic wall thickening and invasion of adjacent structures, findings highly suggestive of malignancy. Endoscopic biopsies were inconclusive in all cases. Definitive diagnosis was established through histopathological examination of the surgical specimen, revealing Actinomyces colonies. All patients underwent surgical resection followed by prolonged antibiotic therapy. Three patients had favorable postoperative outcomes; one patient died of postoperative sepsis secondary to colonic perforation with thoracic extension. Conclusions: Abdominal actinomycosis is an uncommon entity that should be considered in the differential diagnosis of pseudotumoral colonic lesions. Histopathological confirmation remains essential, and combined medical-surgical management constitutes the optimal therapeutic approach.
Keywords: Colon neoplasm. Diverticulitis. Colon volvulus. Chronic constipation. Colonoscopy.