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Actinomycosis is an inflammatory disease caused by Actinomyces (oral commonly existing bacterium); the head and neck region is one of its favorite sites. We present a case of left submandibular mass after operating on tongue cancer, which was a histopathologically epidermoid cyst with Actinomyces israelii, where we excised the mass under general anesthesia. Before the operation, we suspected that the mass was likely to be a neck recurrence of the tongue cancer, since positron emission tomography (PET) indicated the standardized uptake value to be 9.9 and both computed tomography (CT) and magnetic resonance images also showed a suspicion of neck recurrence of the tongue cancer. In the literature, chronic Actinomycosis shows mild inflammation and also enhanced CT and PET images that are similar to those of malignant tumors. When enhanced CT or PET images are observed, suspecting malignant tumors, a chronic mild inflammatory disease like actinomycosis is also one of the differential diagnoses.

An epidermoid cyst with Actinomycosis israelii suspected neck recurrence of tongue cancer