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Case Report
Cesarean scar pregnancy mimicking a pseudo-gestational sac: A case report with magnetic resonance imaging findings
1 MD, Resident, Gynecology and Obstetrics, Chibune General Hospital, Osaka City, Osaka, Japan
2 MD, PhD, Attending, Gynecology and Obstetrics, Chibune General Hospital, Osaka City, Osaka, Japan
3 MD, Attending, Radiology, Chibune General Hospital, Osaka City, Osaka, Japan
4 MD, Fellow, Gynecology and Obstetrics, Chibune General Hospital, Osaka City, Osaka, Japan
Address correspondence to:
Hitomi Futaki
3-29-3, Fuki-machi, Nishiyodogawa-ku, Osaka City, Osaka 555-0034,
Japan
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Article ID: 100028G06HF2022
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How to cite this article
Futaki H, Oki N, Maeda T, Kashima Y, Inagaki M, Yoshida S. Cesarean scar pregnancy mimicking a pseudo-gestational sac: A case report with magnetic resonance imaging findings. Edorium J Gynecol Obstet 2022;7(2):5–9.ABSTRACT
Introduction: A corpus luteal cyst may reportedly be misidentified as an ectopic gestational sac. We report a case of cesarean scar pregnancy mimicking a pseudo-gestational sac, to differentiate between the two entities and diagnose correctly.
Case Report: A 42-year-old woman with four previous cesarean sections, at 7 weeks of gestation, was suspected of an unknown site pregnancy. Transvaginal Doppler ultrasonography showed a small cystic structure accompanied by neither a yolk sac nor surrounding marginal flow, adjacent to the uterine scar, and a 16-mm-large low-echo area with a white ring in the left adnexa. Pelvic magnetic resonance imaging also demonstrated a small cystic structure without contrast enhancement resembling a pseudo-gestational sac adjacent to the cesarean scar. Moreover, a cystic structure with ring-enhancement beside the left ovary, which mimicked an ectopic gestational sac, was also detected. Given these imaging findings and slightly elevated serum β-human chorionic gonadotropin (β-hCG) levels, ectopic pregnancy in the left fallopian tube could not be ruled out. She underwent laparoscopic surgery and uterine content removal, which resulted in intrauterine miscarriage. The cystic structure partially resected from a marginal area in the ovary appeared to be a luteal cyst.
Conclusion: For correct diagnosis and appropriate treatment, the clinical circumstances should be fully considered without excessive reliance on imaging findings.
Keywords: Cesarean scar pregnancy, Ectopic pregnancy, Gestational sac, Miscarriage
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Acknowledgments
We would like to thank Editage (https://www.editage.com) for English language editing.
Author ContributionsHitomi Futaki - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Noriyoshi Oki - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Tetsuo Maeda - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Yoko Kashima - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Mieko Inagaki - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Shigeki Yoshida - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Hitomi Futaki et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
