A 38-year-old woman presented with mild intermittent lower abdominal pain. Six months previously, she had been thought to have had a complete abortion after heavy bleeding at eight weeks’ gestation.Serum β-hCG was negative and serial ultrasound examinations showed a persistent 4.8 x 3.5 x 4.2 cm solid adnexal mass adjacent to the right ovary. A diagnosis of chronic ectopic pregnancy was made preoperatively based on pelvic MRI (Figure 1), which showed a complete hemosiderin rim around a mixed intensity mass anterior to the ovary.At laparoscopy the mass was found to be in the right fallopian tube and adherent to the omentum and pelvic sidewall. Adhesiolysis and salpingectomy were performed (Figure 2). Histopathologic examination confirmed a ruptured tubal pregnancy with degenerated chorionic villi and chronic inflammation.Figure 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)Consent to publish these images has been obtained from the patient. A 38-year-old woman presented with mild intermittent lower abdominal pain. Six months previously, she had been thought to have had a complete abortion after heavy bleeding at eight weeks’ gestation. Serum β-hCG was negative and serial ultrasound examinations showed a persistent 4.8 x 3.5 x 4.2 cm solid adnexal mass adjacent to the right ovary. A diagnosis of chronic ectopic pregnancy was made preoperatively based on pelvic MRI (Figure 1), which showed a complete hemosiderin rim around a mixed intensity mass anterior to the ovary. At laparoscopy the mass was found to be in the right fallopian tube and adherent to the omentum and pelvic sidewall. Adhesiolysis and salpingectomy were performed (Figure 2). Histopathologic examination confirmed a ruptured tubal pregnancy with degenerated chorionic villi and chronic inflammation. Consent to publish these images has been obtained from the patient.