A 30-year-old woman, gravida 4 para 3, presented with abdominal and vaginal pain. Although she had a copper intrauterine device (IUD) in place, she was 12 weeks pregnant, confirmed by the date of her last menstrual period and β-human chorionic gonadotropin level (586 U/L). An ultrasound revealed a 6.4 × 4.6 × 5.1 cm complex mass with a gestational sac and fetal pole oriented along the medial margin of the left ovary (left top image). The fetal pole measured 7 weeks and 1 day. The IUD was observed in good position with its inferior margin above the internal orifice of the cervix uteri.
The patient subsequently underwent laparoscopy and an ectopic pregnancy was visualized arising from the left ovary (left bottom image). An uncomplicated left salpingooophorectomy was performed. The left ovary and tube demonstrated necrotic villi and blood clots involving the ovarian stroma. The fallopian tube was histologically unremarkable (right image).
