Suzuki Haruka, Chigusa Yoshitsugu, Hamanishi Junzo, Mandai Masaki, Kondoh Eiji
Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo, Kyoto 606-8507, Japan.
Case Rep Obstet Gynecol. 2020 Jun 16;2020:2417428. doi: 10.1155/2020/2417428. eCollection 2020.
A well-known typical feature of ectopic pregnancy is an evident gestational sac structure outside of the uterus. However, some cases show atypical appearance that is described as a heterogeneous hypervascular mass. We report two cases of ectopic pregnancy that presented heterogeneous findings mimicking gestational trophoblastic diseases but were correctly diagnosed as ectopic pregnancies on MRI. The first case was an interstitial pregnancy in which the patient underwent surgical treatment. The second case was a cesarean scar pregnancy that was treated conservatively but showed spurious enlargement of pregnancy-related lesions after the treatment. Both cases lacked myometrial invasion on MRI, and the patients were diagnosed with ectopic pregnancies. Invasive findings on MRI may discriminate ectopic pregnancy from trophoblastic tumors and avoid unnecessary hysterectomy.
异位妊娠一个众所周知的典型特征是子宫外明显的妊娠囊结构。然而,一些病例表现出非典型外观,被描述为异质性高血管肿块。我们报告两例异位妊娠病例,其表现为异质性表现,类似妊娠滋养细胞疾病,但在MRI上被正确诊断为异位妊娠。第一例是间质部妊娠,患者接受了手术治疗。第二例是剖宫产瘢痕妊娠,采用保守治疗,但治疗后妊娠相关病变出现假性增大。两例在MRI上均无子宫肌层浸润,患者被诊断为异位妊娠。MRI上的浸润性表现可将异位妊娠与滋养细胞肿瘤区分开来,避免不必要的子宫切除术。