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The paper reports a rare case of ovarian ectopic pregnancy in a 34-year-old woman who presented only with amenorrhea and had no other complaints, remaining clinically stable with a positive pregnancy test. Pelvic examination and transvaginal ultrasound showed a right adnexal mass (~5 cm) without a gestational sac, an endometrial thickness of 25 mm, and an embryo with crown-rump length consistent with about 7 weeks gestation in the right adnexal area; laparoscopy and subsequent laparoscopic right salpingo-oophorectomy confirmed the diagnosis. The authors emphasize that ovarian ectopic pregnancy can be difficult to diagnose and may be asymptomatic, and that definitive diagnosis is surgical and histopathologic, with the note that treatment can require radical surgery in some situations. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.
Abstract
Ovarian pregnancy caused by the implantation of the fertilized ovum in the ovary is a rare type of ectopic pregnancy. In this study, our aim is to present an ovarian ectopic pregnancy case without any complaints except amenorrhea. A 34 year-old woman, gravida 2, para 1, was referred to our clinic with the diagnosis of ectopic pregnancy by the center which she had been admitted due to amenorrhea. She had no complaints and was clinically stable; however her pregnancy test was positive. Uterine bleeding was not observed and roughly 5 cm smooth edged and mobile right adnexal mass showing no tenderness with palpation was detected during pelvic examination. Transvaginal sonography showed that there was an endometrium in 25 mm thickness and there was no gestational sac. Left ovarian logy was normal, but an exitus embryo with a crown-rump length (CRL) measuring 11 mm (at 7 weeks, 2 days gestation) was detected on the right adnexal area. It was recorded that there was no fluid in the pouch of Douglas and the right ovary could not be distinguished. Laparoscopy was suggested and then laparoscopic right salpingo-oophorectomy was performed upon detection of ovarian pregnancy. Abdominal pain is the most frequent complaint in almost all ovarian ectopic pregnancy. Our patient is interesting because it is asymptomatic. The diagnosis of ovarian ectopic pregnancy is very difficult; patients may be asymptomatic and clinically stable. Ovarian ectopic pregnancy should be taken into consideration in the differential diagnosis of each ectopic pregnancy. The diagnosis is made surgically and histopathologically. Today, although laparoscopic conservative surgery is performed in the treatment, radical surgery may sometimes be required. [Cukurova Med J 2015; 40(Suppl 1): 42-46]
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Çukurova Üniversitesi Tıp Fakültesi Dergisi (Mar 2015)
Ovarian Ectopic Pregnancy in an Asymptomatic Patient
Abstract
Ovarian pregnancy caused by the implantation of the fertilized ovum in the ovary is a rare type of ectopic pregnancy. In this study, our aim is to present an ovarian ectopic pregnancy case without any complaints except amenorrhea. A 34 year-old woman, gravida 2, para 1, was referred to our clinic with the diagnosis of ectopic pregnancy by the center which she had been admitted due to amenorrhea. She had no complaints and was clinically stable; however her pregnancy test was positive. Uterine bleeding was not observed and roughly 5 cm smooth edged and mobile right adnexal mass showing no tenderness with palpation was detected during pelvic examination. Transvaginal sonography showed that there was an endometrium in 25 mm thickness and there was no gestational sac. Left ovarian logy was normal, but an exitus embryo with a crown-rump length (CRL) measuring 11 mm (at 7 weeks, 2 days gestation) was detected on the right adnexal area. It was recorded that there was no fluid in the pouch of Douglas and the right ovary could not be distinguished. Laparoscopy was suggested and then laparoscopic right salpingo-oophorectomy was performed upon detection of ovarian pregnancy. Abdominal pain is the most frequent complaint in almost all ovarian ectopic pregnancy. Our patient is interesting because it is asymptomatic. The diagnosis of ovarian ectopic pregnancy is very difficult; patients may be asymptomatic and clinically stable. Ovarian ectopic pregnancy should be taken into consideration in the differential diagnosis of each ectopic pregnancy. The diagnosis is made surgically and histopathologically. Today, although laparoscopic conservative surgery is performed in the treatment, radical surgery may sometimes be required. [Cukurova Med J 2015; 40(Suppl 1): 42-46]
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