ABSTRACT
Introduction: A 54 years old lady who presented with constitutional symptoms of lethargy, weight loss and asthenia. She had been extensively evaluated for a possible gynaecological malignancy but with no definitive outcome. The symptoms were persistent and a decision had to be made towards Surgery in The present climate of The COVID19 pandemic. Method(s): Following oncology multi disciplinary meeting outcome she was taken up for a total abdominal hysterectomy and bilateral salpingo-oophrectomy. She was noted to have an incidental finding of an extensive tumour infiltrating The liver, colon, anterior abdominal wall and The urinary bladder. A surgical resection with ileostomy was performed on suspicion of an underlying malignancy. Result(s): The histopathological diagnosis revealed a picture of actinomycosis which had evaded us previously. Following this she was treated with prolonged course of antibiotics and has recovered well, thus altering our entire management plan. Conclusion(s): Actinomycosis albeit rare is an interesting mimic of tumours. This case also delves into The on-table decision making when in doubt about cancer.