Hyperreactio luteinalis presented with abdominal pain during third trimester: a case report

Hyperreactio luteinalis is a rare bening condition presented with cystic enlargement of both ovaries. This condition is generally associated with trophoblastic disease, fetal hydrops and multiple pregnancies. A 28 years old G1 P0 woman has admitted to hospital at 33 week of spontaneous twin pregnancy with bilateral pelvic pain. Ultrasound examination demonstrated multiple anechoic cystic lesions in both ovaries. The patient underwent primary cesarean section delivery at 34 weeks 4 days due to twin pregnancy. Intraoperative inspection of the pelvis revealed that the ovaries were distinctly enlarged due to multiple cysts 2 to 4 cm in diameter. Perioperative follow up was uneventfull. We performed pelvic ultrasound 6 weeks after delivery and we confirmed normal ovaries without residual cyst.
Hyperreactio luteinalis usually regress after pregnancy. Surgery may be necessary in case of ovarian torsion or uncontrolled hemorrhage. Postpartum follow-up is recommended in all presumptive cases in which histological confirmation has not been established. In the presented case, conservative management allowed preservation of both ovaries.

Keywords

Adnexal mass, hyperreactio luteinalis, twin pregnancy

	File/Dsecription
	Figure 1 Ultrasound image of large multicystic right ovary
	Figure 2 Intraoperative findings of large ovaries and corpus uteri