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This case report describes a patient with an atypical presentation that illustrates the diagnostic difficulty of ROEP. Due to overlapping clinical features, it was initially misdiagnosed as an ovarian malignancy. We review relevant clinical symptoms, \u03b2HCG trends, and imaging findings that should be evaluated together when considering differential diagnoses. Although most ROEPs are ultimately diagnosed intraoperatively and by histopathology, this case report highlights key diagnostic decision points in the setting of ambiguous clinical and radiologic findings.<\/jats:p>","DOI":"10.1155\/carm\/2904664","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T18:35:32Z","timestamp":1758738932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Misdiagnosis of a Ruptured Ovarian Ectopic Pregnancy as Ovarian Malignancy: Case Report and Literature Review"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2986-682X","authenticated-orcid":false,"given":"Rebecca","family":"Shin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Neal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Abidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"e_1_2_9_1_2","volume-title":"Ectopic Pregnancy","author":"Mummert T.","year":"2024"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27549"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/0974-1208.57231"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.18396"},{"key":"e_1_2_9_5_2","first-page":"851","article-title":"What is the Significance of the Human Chorionic Gonadotropin Value in Ectopic Pregnancy?","volume":"74","author":"DiMarchi J. 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