case_images: PMC9823161_01
case_images: Transvaginal ultrasound scan.. Transvaginal ultrasound scan revealed absence of intrauterine gestational sac. A complex mass measuring 1.2 x 0.9 x 1 cm was seen (white arrow) close to the left ovary (LO) and was suspected to be a gestational sac at the left adnexa There was minimal fluid in the pouch of Douglas (arrow head) (A). Follow up transvaginal ultrasound 4 days later showed that the mass has increased in size (1.49 x 1.19 x 1.44 cm) (arrow heads) which contained a well-defined yolk sac (yellow arrow) (B). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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case_images: There was minimal fluid in the pouch of Douglas (Fig. 1A). The intraperitoneal fluid did not increase in volume (Fig. 1B).
case_images: Laparoscopic findings.. Laparoscopy showed that the left fallopian tube (arrow head) and ovary were normal and mobile (A) both ovaries were normal and mobile. Ectopic pregnancy of 2 cm wide having minimal bleeding was located on the left posterior wall of the peritoneum behind the uterus 1 cm above the uterosacral ligament (arrow head) (B).
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case_images: At laparoscopy the uterus was of normal size, both tubes looked normal with no evidence of tubal pregnancy (Fig. 2A), both ovaries were normal and mobile. Ectopic pregnancy of 2 cm wide having minimal bleeding was located on the left posterior wall of the peritoneum behind the uterus, 1 cm above the uterosacral ligament (Fig. 2B).
case_images: H & E stain.. H & E stain, x10 showing chorionic villi. Each villous is formed of a central mesenchymal core (black arrow) which is rimmed by syncytiotrophoblasts and cytotrophoblasts (white arrows). A central blood vessel is visualized (yellow arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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case_images: Histopathology confirmed the presence of large first trimester chorionic villi formed of stroma and covered by two layers of cells, cytotrophoblast and syncytiotrophoblast (Fig. 3).