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A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy

A 24-year-old patient with 7-week amenorrhoea consulted for vaginal bleeding without abdominal pain. Ultrasonography revealed a 7 × 4 cm solid right pelvic mass. There was no visible intrauterine gestational sac. The serum β-human chorionic gonadotropin (β-hCG) level was 11 998 IU/l. Emergency lapar...

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Published in:BMJ case reports 2012-06, Vol.2012 (may30 1), p.bcr0120125577-bcr0120125577
Main Authors: Rozenholc, Alexandre, Abdulcadir, Jasmine, Pelte, Marie-Françoise, Petignat, Patrick
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Abdulcadir, Jasmine
Pelte, Marie-Françoise
Petignat, Patrick
description A 24-year-old patient with 7-week amenorrhoea consulted for vaginal bleeding without abdominal pain. Ultrasonography revealed a 7 × 4 cm solid right pelvic mass. There was no visible intrauterine gestational sac. The serum β-human chorionic gonadotropin (β-hCG) level was 11 998 IU/l. Emergency laparoscopy was performed for a presumptive diagnosis of ectopic pregnancy. At laparoscopy, the right ovary was enlarged with a non-haemorrhagic 7 × 4 cm solid lesion, which was resected. The histological diagnosis was a dysgerminoma with immunohistochemistry showing nests of syncytiotrophoblastic cells, which were the origin of the hCG production. There was no pregnancy, either intrauterine or ectopic. There was no evidence of metastasis from the dysgerminoma on the positron-emission tomography scanner. The patient underwent a second procedure for surgical staging of this ovarian germ-cell tumour. This ovarian dysgerminoma was staged FIGO 1A, and the patient did not receive adjuvant therapy. There was no recurrence at the last 8-month follow-up.
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language eng
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source PubMed Central (Open access)
subjects Black
Chorionic Gonadotropin, beta Subunit, Human - blood
Cysts
Diagnosis, Differential
Dysgerminoma - blood
Dysgerminoma - diagnostic imaging
Dysgerminoma - surgery
Europe (West)
Female
Humans
Laparoscopy
Laparoscopy - methods
Learning from Errors
Ovarian Neoplasms - blood
Ovarian Neoplasms - diagnostic imaging
Ovarian Neoplasms - surgery
Ovaries
Pelvis - diagnostic imaging
Phosphatase
Pregnancy
Pregnancy complications
Pregnancy, Ectopic - diagnosis
Tumors
Ultrasonic imaging
Ultrasonography, Prenatal - methods
Uterus
Young Adult
title A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy
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