A 38-year-old female with an etonogestrel implant in place and history of previous ectopic pregnancy presented with acute abdominal pain and vaginal bleeding. She was found to have a beta-hCG of >12,000 mIU/mL and free fluid noted on a focused assessment with sonography in trauma exam. She underwent an emergent diagnostic laparoscopy due to the suspicion of a ruptured ectopic pregnancy. Findings at the time of surgery included a normal-appearing uterus and left fallopian tube, a surgically absent right fallopian tube and large volume hemoperitoneum with a rapidly expanding left retroperitoneal hematoma. A postoperative computerized tomography (CT) angiogram suggested active bleeding from a pseudoaneurysm of the left renal artery which was successfully embolized by interventional radiology. Biopsy confirmed gestational trophoblastic neoplasia (GTN) after metastases to the brain. In this report, we describe the details of this case of GTN with an atypical presentation.

中文翻译：

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腹膜后血肿作为绒毛膜癌的非典型表现：病例报告。

一名 38 岁女性，植入依托孕烯，有宫外孕史，出现急性腹痛和阴道流血。在创伤检查中超声检查的集中评估中发现，她的 β-hCG 值 >12,000 mIU/mL，并且有游离液体。由于怀疑宫外孕破裂，她接受了紧急诊断性腹腔镜检查。手术时的发现包括外观正常的子宫和左侧输卵管、手术切除的右侧输卵管和大量腹膜积血，并伴有迅速扩大的左侧腹膜后血肿。术后计算机断层扫描（CT）血管造影显示左肾动脉假性动脉瘤有活动性出血，经介入放射学成功栓塞。脑转移后活检证实妊娠滋养细胞肿瘤（GTN）。在这篇报告中，我们以非典型的表现方式描述了GTN这个案例的细节。