Chronic ectopic pregnancy diagnosed incidentally in an infertile woman: a case report

Chronic ectopic pregnancy is an enigma. The clinical presentation can be mild, with absent or subtle symptoms. The high incidence of negative pregnancy tests and the poor specificity of sonographic patterns can be misleading, and the correct diagnosis is sometimes established only at surgery or even histopathologically after the operation. We report the first case of a woman who was accidentally diagnosed with chronic ectopic pregnancy during diagnostic laparoscopy performed as part of a routine investigation for primary infertility.

A 28-year-old woman underwent laparoscopyfor infertility. She had a regular menstrual cycle and was asymptomatic. She gave a history of a possible but unconfirmed miscarriage earlier. Her hormone profile was normal apart from a slightly raised prolactin level. An earlier ultrasound showed a polycystic appearance of the ovaries. Laparoscopy was done on the 25th day of the menstrual cycle, and beta-human chorionic gonadotropin was negative. At laparoscopy, a 2-cm mass wasfound in the right fallopian tube. There was no free blood in the pelvis, and no adhesions. Both tubes were patent at hydrotubation. The mass was excised laparoscopically, and histology confirmed a diagnosis of chronic ectopic pregnancy.

A review of articles on chronic ectopic pregnancy confirmed the difficulty in diagnosing this condition preoperatively.