Presentation
Multipara patient presented with positive B-HCG and 7 days history of vaginal spotting.
Patient Data
The left ovary appears prominent with a cyst measuring about 3.2 x 2.3 cm showing a ring of fire sign, possibly suggesting corpus luteal cyst, as well as an adnexal tubular structure seen between the left ovary and the uterus measuring about 1.3 cm in diameter with internal turbid fluid content and no detectable vascularity, most likely suggesting a hematosalpinx. Features are raising concern for possible left-sided ectopic pregnancy.
Pathology confirmed ectopic pregnancy.
Case Discussion
Ninety-five percent of ectopic pregnancies are tubal and occur most commonly in the ampulla of the fallopian tube. An adnexal mass that is separate from the ovary is a characteristic finding of a tubal ectopic pregnancy on all imaging modalities.
Ultrasound diagnosis of an ectopic pregnancy should be based on the positive identification of an adnexal mass rather than the absence of a gestational sac in the uterine cavity.
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