This is the description of the case of a 22 year old patient with low back pain and sciatica on the right side investigated by lumbar Dimer-X-Myelography. The result of the examination was an impression in the contrast column at the L5/S 1 level on the right. At operation an intradural tumour, plum-sized, well-defined, and blue-black in colour, was found and removed. Histologically the tumour was melanotic and of high cellular density, with spindle-shaped cells as well as giant cells, with round nuclei, considerable polymorphism, and atypical mitoses. On the basis of the operation finding, the clinical course, and the histology, the diagnosis is melanotic nerve sheath tumour of the first sacral root. For two years following operation the patient has experienced no discomfort.

The course of a right ovarian pregnancy advanced up to the 35th week is described. The only pathognomonical symptom was a constant retrocervical tumor which was not identified as the contracted uterus. The analysis of this and 16 further cases of such ovarian pregnancies published between 1950 and 1981 leeds to the following conclusions: 1. Predisponant factors for an ovarian pregnancy occurring in a frequency of ca. 1:30,000 of all pregnancies are inflammatory diseases, surgery of the pelvis and fertility-disorders in the case-history. 2. The course of the ovarian pregnancy progreeded up to the third trimester in around 12% of the cases is characterised by an almost complete lack of symptoms. Vaginal bleedings and pain in the adnex-area may occur. 3. The monitoring as cardiotocography, chemical analysis of the placental function and the ultrasonography do not provide any clear findings to confirm the diagnosis. 4. As essential clinical indications can be considered a tumor in the pelvis of constant size discovered during the pregnancy mainly in combinations with a dislocated cervix of the uterus, a persistent anomaly of the fetal position, and a fetus palpable directly under the abdominal wall. 5. If an ovarian pregnancy is assumed an immediate operative revision is indicated. Exceptionally, in the second half of the pregnancy a delay of the operation can be justified until the fetus is able to survive. 6. The surgery of the advanced ovarian pregnancy should be as conservative as possible and reduced to the removal of the concerning adnexe.

In diesem kasuistischen Beitrag werden die Symptomarmut, die M6glichkeiten der Fehldeutung in der Diagnostik sowie die Entwicklung einer akuten Plazentainsuffizienz und die konservative operative Therapie einer bis zur 35. Woche fortgeschrittenen Ovarialgravidit/it exemplarisch dargestellt.Blutungen in der Friihschwangerschaft und eine konstante ,,retrozervikale Resistenz" waren die einzigen Besonderheiten in der Schwangerschaft der 30j~ihrigen II-gravida, I-para.

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