Chronic ectopic pregnancy. A case report

Chronic ectopic pregnancy is a clinical condition which is often difficult to diagnose, Infact, the symptoms are generally mild, pregnancy tests are often false-negative and sonographic images are similar to other gynecologic diseases, Surgery is frequently necessary for diagnosis In September 1996 a 30-year-old woman who had been suffering from severe pelvic pain for 4 months, with regular menstrual cycles and several negative quantitative beta-hCG titers, was referred to our institution Physical examination revealed the presence of a tender left adnexal mass and a uterus of normal dimensions. Transvaginal sonographic examination suggested bilateral ovarian endometriosis. At laparoscopy an adnexal left mass involving the tube and ovary, surrounded by dense adhesions and adherent to the posterior aspect of the uterus and to the cecum. was found, suggesting a tube-ovarian abscess. After adhesiolysis, a left salpingectomy and resection of the ovary was performed. Villi were identified in the pathologic specimen and a diagnosis of chronic ectopic pregnancy was carried out. The postoperative period was uneventful and the patient is in good condition with no pain symptoms In conclusion, given the presence of persistent pelvic pain, even with negative beta-hCG titers and regular menses, a possible chronic ectopic pregnancy should not be excluded.