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Chronic ectopic pregnancy mimicking pelvic malignancy.

Edwin Omih1, Argyrios Makris2, Cheng Choy2

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A rare ectopic pregnancy case occurred in a woman with a negative pregnancy test, presenting with a pelvic mass and bowel obstruction. This highlights unusual presentations of ectopic gestation, challenging typical diagnostic approaches.

Keywords:
gynaecology and fertilityobstetricspregnancy

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Area of Science:

  • Reproductive medicine
  • Gynecologic oncology
  • Medical diagnostics

Background:

  • Ectopic pregnancy is a frequent complication during early pregnancy.
  • It typically involves implantation outside the uterus, most commonly in the fallopian tubes.
  • Standard diagnostic methods usually rely on positive pregnancy tests and ultrasound findings.

Observation:

  • A case of ectopic gestation was observed in a patient with atypical symptoms.
  • The patient presented with a negative pregnancy test, a significant pelvic mass, unintended weight loss, and signs of bowel obstruction.
  • These clinical features are highly unusual for a standard ectopic pregnancy diagnosis.

Findings:

  • The diagnostic challenge was compounded by a negative pregnancy test, which is contrary to typical ectopic pregnancy indicators.
  • A large pelvic mass was identified as the primary physical finding.
  • The presence of weight loss and bowel obstruction suggested a complex, potentially advanced, or unusually located ectopic gestation.

Implications:

  • This case underscores the importance of considering ectopic pregnancy even with negative pregnancy tests, especially when clinical signs are suggestive.
  • It emphasizes the need for a comprehensive diagnostic workup, including advanced imaging and differential diagnosis, for atypical presentations.
  • Recognizing such rare scenarios can improve diagnostic accuracy and timely intervention, potentially preventing severe complications like bowel obstruction in ectopic gestation.