A 30-year-old female presents with sharp pelvic pain, vaginal bleeding, and an adnexal mass. What is the most likely diagnosis?

The presentation of sharp pelvic pain, vaginal bleeding, and an adnexal mass in a 30-year-old female is highly suggestive of an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants outside the uterine cavity, commonly in the fallopian tubes. This can lead to significant morbidity if not diagnosed early, as the embryo grows and can cause the tube to rupture, leading to severe pain and internal bleeding.

The symptoms of sharp pelvic pain and vaginal bleeding are classic for an ectopic pregnancy; as the mass develops in the adnexal area, it can be palpated during a physical examination or visualized via ultrasound. Additionally, the timing of these symptoms in the context of missed menstrual periods or positive pregnancy tests further supports the diagnosis, as ectopic pregnancies often occur in women of reproductive age who may not suspect they are pregnant.

In this scenario, the presence of an adnexal mass along with the symptoms indicates a strong likelihood of ectopic pregnancy, making it the most probable diagnosis. Other conditions, while they can present with some overlap in symptoms, do not typically combine all these features in the same way.