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Tubal ectopic pregnancy with molar changes: an uncommon histopathological finding

Ectopic molar pregnancy is an uncommon form of gestational trophoblastic disease and is rarely suspected preoperatively due to its clinical similarity with non-molar ectopic pregnancy. We report a case of a 46-year-old multiparous woman presenting with amenorrhea, abdominal pain, and vaginal bleeding following unsupervised medical termination of pregnancy. Ultrasonography revealed a left adnexal mass suggestive of ectopic pregnancy. The patient underwent exploratory laparotomy with left salpingectomy. Histopathological examination demonstrated hydropic chorionic villi with trophoblastic proliferation, consistent with molar changes. Postoperative β-hCG levels showed an appropriate decline. This case highlights the importance of routine histopathological examination of ectopic pregnancy specimens, as definitive diagnosis cannot be established clinically. Early diagnosis is essential to ensure appropriate follow-up and to detect persistent gestational trophoblastic disease at an early stage.