Abstract: A 36-year old woman was admitted for menolipsis for 71 days and vaginal bleeding for 38 days and aggravation of
vaginal bleeding with abdominal distension for 10 days. Gynecological examination revealed marked hysterauxesis without
tenderness with a high HCG level. CT examination led to the misdiagnosis of trophoblastic tumor with lymph node metastasis
of the left iliac vessels. The patient underwent subsequent laparotomy, and a huge pelvical hematoma with maximum
diameter of 20 cm was found, for which left salpingectomy was performed. Pathologic examination of the surgical specimen
supported the diagnosis of old tubal pregnancy. This case represents a rare clinical entity of old ectopic pregnancy manifested
as a painless huge pelvic mass that can be easily misdiagnosed based on radiographical findings only.