Cytologically Diagnosed Ovarian Carcinoma Turned Out To Be a Case of Chronic Ectopic Pregnancy

The diagnosis of chronic ectopic pregnancy is often difficult as there is a shortage of literature in which this disease is diagnosed as an entity separate from the condition of acute ectopic pregnancy. Experience with fine needle aspiration cytology in chronic ectopic pregnancy is not reported previously. A 29-year-old para 3 woman presented with lower abdominal pain and irregular menstruation since two months. Transvaginal ultrasonography showed a well-defined heterogeneous, solid-cystic right adnexal mass with normal serum beta HCG, and mildly elevated CA 125 level. Fine needle aspiration cytology (FNAC) from the mass was performed, and cytological findings suggested possibility of serous cystadenocarcinoma. Abdominal hysterectomy with bilateral salpingo-oophorectomy and infra-colic omentectomy was done. Pathological findings were consistent with chronic ectopic pregnancy. It is possible to retrieve trophoblastic cells through fine needle aspiration even after 2 months of tubal rupture and this experience can be utilized to diagnose chronic ectopic pregnancy preoperatively.