A 48-yr-old white female with a 20-yr history of intrauterine device use presented with signs and symptoms suggestive of a disseminated neoplasm with a pelvic primary. A definitive diagnosis of disseminated actinomycosis was made on the basis of computed tomography-guided fine-needle aspiration of a liver lesion. Subsequent laparotomy revealed involvement of the endometrium and of the ovaries and uterine tubes bilaterally. This article indicates the usefulness of fine-needle aspiration in the diagnosis of actinomycosis in this case.