A Case of Phlegmon caused by Chronic Pelvic Inflammation mimiking Pelvic Malignancy / 대한산부인과학회잡지

ABSTRACT

Pelvic inflammatory disease (PID) is a common disease associated with gynecologic infection, occurring mainly in fertile women. We report a case of phlegmon caused by chronic PID mimicking pelvic malignancy in a 39-year-old woman. The patient suffered from chronic pelvic pain, intermittent fever, and dysuria. A palpable lower abdominal mass was associated with progressive weight loss. A pelvic MRI revealed a 9x8x7cm sized, ill-defined soft tissue mass in the right pelvic cavity. On exploratory laparotomy, the pelvic mass was severly adhesed to the small intestine, mesentery, and urinary bladder. An incisional biopsy of the pelvic mass was performed. Histologically, the pelvic mass was composed of inflammed fibrous tissue with granulation tissue proliferation. The patient was treated with metronidazole and ciprofloxacin for two weeks. Fever and abdominal pain were relived. On a follow up abdomino-pelvic CT, the pelvic mass was not visible. Awareness of such an unusual case of chronic PID mimicking pelvic malignancy will facilitate a more accurate diagnostic approach for a variety of pelvic mass lesion.