case_images: PMC11702392_01
case_images: (a) The endometrium appears thick and echogenic, with a maximum thickness of 17 mm. No internal vascularity is observed within the endometrial content, which is suggestive of retained hemorrhage. There is no evidence of an intrauterine pregnancy. (b) A complex extra-adnexal cyst with an echogenic wall is detected in the paraovarian region (separate from the ovary), measuring 28 x 20 mm2. This cyst exhibits the 'ring of fire' sign, indicating prominent peripheral vascular flow. The cyst contains two echogenic components, resembling fetal poles. The crown-rump length (CRL) of 10 mm corresponds to a gestational age of approximately 7 weeks and 1 day, while the CRL of 8 mm corresponds to approximately 6 weeks and 6 days. No fetal cardiac activity is observed.
case_images: CCR3-13-e70080-g001.jpg
case_images: PMC11702392_01_CCR3-13-e70080-g001.jpg
case_images: ccr370080-fig-0001
case_images: Mild free fluid in the pelvic cavity was noted, with no signs of tubal rupture or hemoperitoneum (Figure 1).