Primary twin ovarian pregnancy: case report and review of the literature.

Primary twin ovarian pregnancy is extremely rare. We present one such case in a 25-year-old primigravida who complained of lower abdominal pain and mild vaginal bleeding at 8 weeks after her last menstrual period. Transvaginal sonography revealed an empty uterus and presence of a gestational sac containing 2 dead embryos in the right ovary. The patient underwent unilateral oophorectomy, and histologic studies confirmed a uniovular-diamniotic ovarian pregnancy. A brief review of the literature revealed that primary ovarian pregnancy may occur without any classical antecedent risk factors, and endovaginal sonography can be useful to establish early preoperative diagnosis of ectopic ovarian pregnancy.