Additional biopsy demonstrated "granulation tissue with acute and chronic inflammation". The multidisciplinary tumor board is discussing possible hysterectomy, partial cystectomy vs radical cystectomy with ileal orthotopic neobladder. However, considering the presence of an IUD, consideration for actinomycosis is given, and a CT-guided biopsy is repeated, revealing:
Morphologic area is consistent with actinomyces with surrounding immune reaction. Background inflammatory tissue.
The patient undergoes medical treatment, and a follow-up pelvic MRI demonstrates resolution of the previously seen mass.