Pregnancy implanted in the fibromuscular layer of the cervix: a case report.

BACKGROUND: Implantation sites other than the fallopian tube are rarely encountered in ectopic pregnancies. No cases of an implantation in the cervical muscular layer had been reported at this writing.

CASE: A 32-year-old woman, gravida 1, para 0, induced abortion 1, was admitted to our hospital with the suspicion of ectopic pregnancy. Although an explorative laparoscopy and dilation and curettage failed to detect a definite implantation site, postoperative tranvaginal ultrasonography (US) and magnetic resonance imaging (MRI) disclosed a pregnancy implanted in the fibromuscular layer of the cervix. Chemotherapy with methotrexate was successful, and the patient's reproductive potential was preserved. A fine tract connecting the cervical canal to the gestational area, which was observed both before and after treatment, appeared to be involved in the etiology.

CONCLUSION: This case demonstrates that the cervical wall can be the site of implantation and that such an unusual ectopic pregnancy can be managed conservatively by early diagnosis with repeat US and MRI.