Actinomycotic pelvic inflammatory disease simulating malignancy.

The protean and indolent nature of pelvic actinomycosis combined with the rarity of the disease poses a diagnostic dilemma. Woody induration and pelvic fibrosis may be present to such a degree that a diagnosis of pelvic malignancy is entertained. Early diagnosis and aggressive antibiotic therapy prior to definitive surgical management, even in the face of extensive anatomic changes, may enable the surgeon to perform relatively conservative surgery, obviating the need for procedures usually reserved for malignant disease.