HYPERREACTIO LUTEINALIS ASSOCIATED WITH PREGNANCY - A CASE-REPORT ANDREVIEW OF THE LITERATURE

Hyperreactio luteinalis is a condition associated with bilateral and, in rare cases, unilateral ovarian enlargement due to theca lutein cyst s. Hyperreactio luteinalis is a benign condition, usually found incide ntally at cesarean section, which can appear anaplastic and lead to un necessary ovarian resection. A 21-year-old Hispanic woman, G2P1, prese nted at 19 weeks with a singleton pregnancy, bilaterally enlarged ovar ies, and a normal beta hCG. Over the next four months, her ovaries inc reased 75% in size with the right ovary becoming entrapped in the pelv is. The patient underwent a primary low transverse cesarean section. T he ovaries had an anaplastic appearance and on frozen section revealed multiple benign theca lutein cysts. There are 51 reported cases of hy perreactio luteinalis associated with a normal pregnancy in the litera ture. It is estimated that approximately 60% of the cases of hyperreac tio luteinalis unassociated with trophoblastic disease occur with norm al singleton pregnancy. There are multiple benign ovarian lesions incl uding hyperreactio luteinalis that can mimic ovarian neoplasms. Accord ingly, it is important to exclude these from the differential diagnosi s via a wedge biopsy and frozen section to avoid unnecessary surgical excision.