• Medicina · Apr 2023

    Case Reports

    Trophoblastic Tissue Reimplantation below the Spleen Following Laparoscopic Bilateral Salpingectomy for Ectopic Tubal Pregnancy: A Case Report.

    • Dominyka Surgontaitė, Artūras Sukovas, Dalia Regina Railaitė, Tautvydas Jankauskas, Arnoldas Bartusevičius, and Eglė Bartusevičienė.
    • Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania.
    • Medicina (Kaunas). 2023 Apr 3; 59 (4).

    BackgroundTrophoblastic tissue reimplantation after laparoscopic salpingectomy is a very rare complication. These cases may present a diagnostic challenge and the majority of patients need a surgical treatment.Case PresentationA 31-year-old patient came to a tertiary referral center for nausea and pain in the upper left abdominal quadrant. Ultrasound and abdominal CT scan showed a 68 × 60 × 87 mm size heterogenic mass below the spleen with arterial extravasation from the lower spleen pole. Recent history of surgery for ectopic pregnancy and serum hCG testing allowed to diagnose extratubal secondary trophoblastic tissue reimplantation below the spleen. Embolization of the bleeding vessel and successful treatment with methotrexate was achieved.ConclusionsIn cases of a nondisseminated trophoblastic tissue reimplantation, consider embolization and treatment with methotrexate if the patient is hemodynamically stable; thus, secondary surgical treatment is preventable.

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