Ectopic ovarian pregnancy. Case presentation.

Abstract

An ectopic pregnancy corresponds to the implantation and development of the blastocyst outside the endometrial cavity. It occurs in 1-2% of all gestations. 95% occur in the uterine tube, 3% of the cornwall, 1.4% abdominal, 0.3% ovarian, 0.2% cervical and 0.1% intraligamental. The etiology of this type of pregnancy remains undetermined. However, some hypotheses have suggested interference in the release of the egg from the broken follicle, associated with tubal dysfunction.

 The case of a 38-year-old patient is presented, who underwent oophorectomy and right salpingectomy at another institution, referring to the pathology department of our hospital with the following clinical data: patient without known pathological personal history, consulted for six-week amenorrhea, discomfort pain in the right iliac fossa, positive pregnancy test and ultrasound with enlarged right ovary, uterine tube and uterine size preserved without lesions.

The macroscopic examination received an ovary measuring 4.5x3.5x3 cm., With a smooth surface with congestive areas. At the cut a cystic formation of 2.3 cm is observed. in diameter in which an embryo of 0.7x0.5x0.5 cm is observed, implanted therein. No signs of rupture or ovarian hemorrhage. In addition, the uterine tube was recognized, measuring 7x0.6 cm., With smooth and shiny serosa. At permeable power outage. No macroscopic lesions.

Material was sent for histological study which showed ovarian parenchyma with hemorrhagic sufferings, corial villi and trophoblast without atypia, with which the diagnosis of ovarian ectopic pregnancy was made. The uterine tube showed no significant lesions.

Ovarian ectopic pregnancy is extremely rare. Diagnosis represents a challenge in clinical practice, although transvaginal ultrasound and B-HCG have facilitated the diagnosis of ectopic pregnancy, this is not the case for cases where the diagnosis is normally made during surgery. A high index of suspicion is necessary to achieve the correct diagnosis and intervene early to preserve the affected ovary.