Size of mass after Methotrexate

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1

Hi there,

I’m just looking to see if anyone has had a similar experience. I have a cornual ectopic, and had one dose of MTX on august 29th (bhcg 3000). Since then, my Bhcg levels have been dropping significantly (2300 on day 7, 1300 on day 14, and 400 on day 20) I did start to have some temporary sever pain, for about 4 days on and off, so I went in for an ultrasound and the mass grew by almost 1cm+ since my MTX injection.

Because my bhcg levels are decreasing so significantly, my OB is not concerned about the increase in size as it is apparently typical after the injection for the mass to increase initially due to inflammation and swelling. There is no activity in the mass, just a gestational sac with what seems to be solid or fluid filled.

Has anyone been in this situation before?

It’s great that my levels are decreasing but it’s terrifying that the mass has grown, especially in the rare and dangerous area that it is located.

2

Dear Lo_s,

I am so sorry to hear of your ectopic pregnancy loss,

You are right a corneal ectopic pregnancy is rare and unfortunately due to this there is very little evidence based research into this type of ectopic pregnancy and any complications.

It is usual for masses to continue to increase in size after methotrexate, however I am not sure when you had the scan, and I would think that it shouldn’t continue tomorrow if your hCG levels are decreasing.

Sadly I am unable to provide you with medical advice, but I would suggest speaking to your medical team to see If they are going to repeat the scan, especially if your pain is continuing. Although I do not wish to alarm you, I do need to remind you to seek urgent medical advice with any worsening bleeding or pain or you feel dizzy and unwell.

Sending much love,

Karen x

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3

Thanks Karen,

It’s definitely scary knowing that there aren’t many resources or studies done on this type of ectopic. My dates of ultrasound and Bhcg are below for reference.

Aug 29 - bhcg 3000 - MTX shot

Sept 2 - bhcg 3180 (day 4)

Sept 5 - bhcg 2300 (day 7)

Sept 13 - bhcg 1300

Sept 14 - TVS (mass 2.5x2.5cm)

Sept 19 - bhcg 260

Sept 19 - TVS (mass 3cm) grew by 5mm

My OB specialist and his team are not concerned about the size as they think it is a reaction from the quickly dying cells as my bhcg levels are decreasing. They say it’s inflammation and swelling. As of last night I haven’t had any more pain. So hopefully that’s the case and it will start to resolve on its own.

In other types of ectopics, from your experience, how much does the mass typically grow initially after MTX ?