“…The absence of teratogenous elements and neoplastic changes would overcome initial misgivings about incipient primary ovari¬ an choriocarcinoma.11 '21 No patient reported by us suffered chronic pelvic inflammation. Evidence for pre-existing pelvic inflamma¬ tory disease in terms of tubal lesions is not often seen in cases of ovarian pregnancy.1'2-5"9« 13"16« 18« 21«25'27-29* 33> 36> [40][41][42] Unfortunately Spiegelberg's report of 1878 has become a part of gynecological lore, from which arises bias against recognizing exceptions to the criteria then laid down and thereafter clarified but exaggerated when construed in English, e.g. the rendering of Spiegelberg's fourth criterion "Nichtbetheiligung der Eileiter an der Bildung des Fruchthalters, ein topographisches Verhalten auf der betroffenen Seite gleich oder ahnlich bei dem grossen Eierstockstumoren vorkommenden"* as "The tube, including the fimbria ovarica, should be intact and the former be clearly separated from the ovary".14 As a result, cases with long-standing tubo-ovarian adhesions or inflammatory tubal involvement secondary to an ovari¬ an pregnancy may unfortunately have gone unreported.…”