Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 9 3 2024 12 08 88 92 EN Somayeh Livani Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran. Alireza Fatemi Minimally Invasive Surgery Research Center, Rasool Akram Hospital Iran,University of Medical Sciences, Tehran, Iran. Moghadese Jahanshahi Department of Obstetrics and Gynecology, School of Medicine, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran. 2024 07 23 2024 10 19 Retained products of conception (RPOC) occur when fragments of the placenta or decidual tissue remain in the uterus, often leading to postpartum hemorrhage. Early and accurate diagnosis, aided by ultrasonography, is essential for appropriate management and prevention of complications. We report a case of a 22-year-old woman admitted to our tertiary medical department with irregular vaginal bleeding and abdominal pain. She had no significant past medical history. Abdominal ultrasonography revealed a normal-sized uterus with homogeneous myometrial echogenicity. However, a heterogeneous echogenic mass, exhibiting considerable vascularity and feeding vessels from the endometrial cavity, was observed in the cervix. Additionally, the patient’s beta human chorionic gonadotropin (Beta-HCG) concentration was positive, with a titer of 201 µ/l, despite her claim of being a virgin. Subsequently, the patient underwent hysteroscopy, during which an infected and malodorous lesion was removed from the uterus, confirming the diagnosis of RPOC. In follow-up assessments, she experienced no complications. To the best of our knowledge, no cases of RPOC located in the cervix have been reported previously, as RPOC is typically expected to be found in the endometrial cavity. This study aims to share our experience in considering the differential diagnosis of RPOC as cervical lesions and highlights the importance of ultrasonography in early pregnancy management. https://crcp.tums.ac.ir/index.php/crcp/article/view/431 https://crcp.tums.ac.ir/index.php/crcp/article/download/431/663