Rani Hephzibah, Kumar Ramesh, Shastri Dinesh
Department of Pathology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
Department of Pathology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India.
BMJ Case Rep. 2025 Feb 16;18(2):e262218. doi: 10.1136/bcr-2024-262218.
One of the extremely rare locations for an ectopic pregnancy is myometrium. Intramyometrial ectopic pregnancy is characterised by an unusual form of implantation wherein the gestational sac is situated deep in the myometrium, separated from the endometrial cavity and fallopian tubes. It accounts for <1% of all ectopic pregnancies. The preoperative diagnosis based on ultrasound findings may mimic a degenerated leiomyoma, thereby posing further diagnostic challenges. We report a case of a woman in her late 20s presenting with abnormal uterine bleeding diagnosed ultrasonographically as posterior wall fibroid. Histopathological evaluation of the myomectomy specimen revealed chorionic villi lined by trophoblastic cells, thereby confirming the diagnosis. This case report aims to increase the awareness about the possibility of this potentially life-threatening rare entity even with normal serum beta-human chorionic gonadotropin levels.
子宫肌层是异位妊娠极其罕见的发生部位之一。子宫肌层内异位妊娠的特征是一种不寻常的着床形式，即妊娠囊位于子宫肌层深处，与子宫内膜腔和输卵管分离。它占所有异位妊娠的不到1%。基于超声检查结果的术前诊断可能会误诊为变性的平滑肌瘤，从而带来进一步的诊断挑战。我们报告一例28岁左右的女性，因异常子宫出血就诊，超声诊断为后壁肌瘤。子宫肌瘤切除标本的组织病理学评估显示有滋养层细胞内衬的绒毛膜绒毛，从而确诊。本病例报告旨在提高人们对这种即使血清β-人绒毛膜促性腺激素水平正常但仍可能危及生命的罕见疾病的认识。
