Table 1.

Summary of patient characteristics and clinical data.

Characteristic	Details
Demographics
Age (years)	40
Gravida/Para	Gravida 4, Para 1
Previous pregnancies	Three induced abortions (dates unavailable)
Risk Factors
Tubal surgery	None
Pelvic inflammatory disease/STI	None
Intrauterine device use	None
Assisted reproductive technology	None
Chronic medical conditions	None
Clinical Presentation
Amenorrhea	49 days
Vaginal bleeding	Intermittent spotting for 23 days
Abdominal pain	Dull lower abdominal pain for 3 days
Associated symptoms	Intermittent rectal pressure
Vital Signs on Admission
Blood pressure (mmHg)	115/70
Pulse rate (beats/min)	78
Body temperature ( °C)	36.5
Laboratory Findings
Serum β-hCG on admission (mIU/mL)	11,633.28
Serum β-hCG on Day 5 (mIU/mL)	19,707.09
Hemoglobin (g/L)	124
White blood cell count (×10⁹/L)	6.8
Platelet count (×10⁹/L)	235
Transvaginal Ultrasonography
Uterine cavity	Heterogeneous endometrium (16 mm), no gestational sac
Left adnexa (initial)	Two thick-walled cystic lesions: 11 × 10 × 9 mm and 8 × 8 × 7 mm
Left adnexa (follow-up, 3 days later)	Two thick-walled cystic lesions: 14 × 13 × 13 mm and 10 × 9 × 9 mm
Left ovary	Cystic lesion (20 × 15 × 15 mm), consistent with physiological cyst
Pelvic free fluid	None
Treatment
Procedures	Diagnostic curettage followed by laparoscopic left salpingectomy
Intraoperative findings	Distended ampullary segment (∼4 cm), bluish-purple tense surface, no rupture
Pathology (curettage)	Secretory-phase endometrium with decidualization and Arias–Stella reaction; no chorionic villi
Pathology (salpingectomy)	Two distinct foci of chorionic villi and trophoblastic cells
Outcome
Postoperative β-hCG (Day 2, mIU/mL)	3,457.94
Postoperative β-hCG (Day 4, mIU/mL)	1,728.62
Recovery	Uncomplicated, discharged on postoperative day 5