Actinomyces israelii may produce vulvar lesions suspicious for malignancy.

BACKGROUND: We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. CASE: A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. CONCLUSION: Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy.