陈旧性宫外孕表现为无痛性巨大盆腔包块并影像学误诊1例

目的报告陈旧性宫外孕表现为无痛性巨大盆腔包块并影像学误诊1例，并分析该病例影像学误诊的原因。方法36岁女
性，主诉停经71 d，阴道流血38 d，加重伴腹胀10 d，妇科检查子宫明显大于孕周，无压痛，人绒毛膜促性腺激素明显增高，CT误
诊为滋养细胞肿瘤并左侧髂血管旁淋巴结转移。结果完善相关准备后行剖腹探查术，术中发现盆腔内一巨大血肿，最大直径
达20 cm，行左侧输卵管切除及血肿清除术，术后病检符合输卵管妊娠。结论陈旧性宫外孕表现为无痛性巨大盆腔包块实属少
见，该病例影像学表现特殊，易误诊。

Old ectopic pregnancy manifested as a painless huge pelvic mass and misdiagnosed by imaging examination: a case report

A 36-year old woman was admitted for menolipsis for 71 days and vaginal bleeding for 38 days and aggravation of
vaginal bleeding with abdominal distension for 10 days. Gynecological examination revealed marked hysterauxesis without
tenderness with a high HCG level. CT examination led to the misdiagnosis of trophoblastic tumor with lymph node metastasis
of the left iliac vessels. The patient underwent subsequent laparotomy, and a huge pelvical hematoma with maximum
diameter of 20 cm was found, for which left salpingectomy was performed. Pathologic examination of the surgical specimen
supported the diagnosis of old tubal pregnancy. This case represents a rare clinical entity of old ectopic pregnancy manifested
as a painless huge pelvic mass that can be easily misdiagnosed based on radiographical findings only.