[Old ectopic pregnancy manifested as a painless huge pelvic mass and misdiagnosed by imaging examination: a case...

A 36-year old woman was admitted for menolipsis for 71 days and vaginal bleeding for 38 days and aggravation of vaginal bleeding with abdominal distension for 10 days. Gynecological examination revealed marked hysterauxesis without tenderness with a high HCG level. CT examination led to the misdiagnosis of trophoblastic tumor with lymph node metastasis of the left iliac vessels. The patient underwent subsequent laparotomy, and a huge pelvic hematoma with maximum diameter of 20 cm was found, for which left salpingectomy was performed. Pathologic examination of the surgical specimen supported the diagnosis of old tubal pregnancy. This case represents a rare clinical entity of old ectopic pregnancy manifested as a painless huge pelvic mass that can be easily misdiagnosed based on radiographical findings only.