Case Report: Acute large bowel obstruction with actinomycosis of the sigmoid colon mimicking neoplasm.

Introduction: Actinomycosis is an uncommon inflammatory bacterial disease caused by Actinomyces species, especially Actinomyces Israeli. Abdominopelvic forms are relatively rare and may involve the colon as a solid mass, mimicking a malignant tumor. Case presentation: A 68-year-old Tunisian man, with a history of diabetes, hypertension, penicillin allergy, and renal failure, presented to the emergency department with abdominal pain, vomiting, and bowel obstruction. CT scan showed an acute intestinal obstruction upstream with obstructive tissular mass at the sigmoid colon. Emergency surgery revealed a sigmoid mass and a pre-perforative cecum. Total colectomy was performed, with ileostomy and distal end closure. Histological examination confirmed Actinomyces infection. The patient was then placed on long-term doxycycline and Bactrim, with no recurrence over a 9-month follow-up period. Conclusion: Abdominal actinomycosis, though rare, presents diagnostic challenges. It can be mistaken for malignancy, leading to unnecessary surgery in non-complicated cases, since it is effectively treated by antibiotics. In complicated cases, a combined approach involving both surgery and antibiotic therapy is necessary until the infection is completely eradicated.

Primary retroperitoneal cavernous hemangioma: An exceptional disease in adulthood.

Primary retroperitoneal cavernous hemangioma is an extremely rare disease in clinical practice. It is classified as a vascular tumor. Only three cases have been reported in the literature. The diagnosis is uncommon due to the lack of specific radiological features. It becomes symptomatic as a consequence of its enormous size or complications like rupture or compression. We herein report a unique case of primary retroperitoneal cavernous hemangioma treated with conventional surgery in a 35-year-old male patient admitted to our department for chronic abdominal pain. Retroperitoneal cavernous hemangioma is an extremely rare vascular tumor in adulthood. Confirmation is made by histopathological examination after total surgical resection.

Mesenteric lipoma revealed by chronic abdominal pain: A rare case report.

Mesenteric lipoma is a rare entity. It can be asymptomatic or revealed by unspecific clinical symptoms. Complete resection of the lipoma is often proposed to prevent complications. We report a case of mesenteric lipoma revealed by chronic abdominal pain, and we performed a literature review regarding this rare condition.

Retroperitoneal schwannoma: Uncommon location of a benign tumor.

Schwannoma is a type of nerve tumor of the nerve sheath. They are preferentially localized on the head, neck, and flexor surfaces of the extremities. Retroperitoneal schwannoma is extremely rare. The diagnosis is uncommon and based on the anatomopathological and immunochemistry examination of the surgical specimen. We herein report an uncommon location of schwannoma treated with conventional surgery in a 53-year-old female patient admitted to our department for chronic abdominal pain. Retroperitoneal schwannoma is a rare disease that occurs in adult females. The histopathological examination is the only reliable examination for the diagnosis after total surgical resection.