A Case Report of Chronic Ectopic Pregnancy: A Silent Entity With a Surgical Diagnosis

TL;DR

This case report describes a rare chronic ectopic pregnancy that was diagnosed surgically due to its subtle symptoms and low hormone levels.

Contribution

The paper presents a rare clinical case emphasizing the need to consider chronic ectopic pregnancy in atypical presentations.

Findings

Chronic ectopic pregnancy can present with low β-hCG levels and nonspecific symptoms.

Surgical exploration is crucial for diagnosis when imaging and hormone tests are inconclusive.

Histopathological confirmation is necessary for definitive diagnosis.

Abstract

Chronic ectopic pregnancy is an uncommon form of ectopic pregnancy, characterized by the persistent implantation of trophoblastic tissue outside the uterine cavity and an insidious progression, making its diagnosis challenging. Unlike the acute form, it typically presents with nonspecific symptoms such as abnormal uterine bleeding and mild pelvic pain, and may mimic other gynecological conditions. We report the case of a 30-year-old female with persistent transvaginal bleeding and ultrasound findings suggestive of a complex adnexal mass, accompanied by low β-human chorionic gonadotropin (hCG) levels. The diagnostic suspicion was confirmed through exploratory laparotomy, revealing a ruptured, organized chronic ectopic pregnancy, which required a left salpingo-oophorectomy. Histopathological examination confirmed the diagnosis. This report highlights the importance of considering this condition in the differential diagnosis of adnexal masses and persistent abnormal uterine bleeding, even in the presence of low β-hCG levels, as well as the significance of surgical intervention for definitive diagnosis and treatment.

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