Hyperreactio luteinalis in a normal singleton pregnancy - A case report

BACKGROUND: Hyperreactio luteinalis rarely occurs in normal singleton pregn ancy. About 50 such cases have been published. This case is noteworthy beca use it resulted in extremely enlarged ovaries and suns accompanied by a hyp erandrogenic state and high level of human chorionic gonadotropin. CASE: A gravida was referred to our department because of large, bilateral, cystic ovaries diagnosed by ultrasonography in the 28th week of gestation. Markedly elevated levels of androgens and human chorionic gonadotropin wer e noted. During the following six weeks the ovarian masses enlarged, and th e hyperandrogenic state worsened. Cesarean section and, because of a bleedi ng right adnexectomy, left ovarian resection were performed. Histology conf irmed the presumed diagnosis of hyperreactio luteinalis. The placenta was u nremarkable. Seventeen weeks after surgery the hormone levels were normal. CONCLUSION: Our case suggests the possibility that in certain cases of hype rreactio luteinalis, an idiopathic elevation of human chorionic gonadotropi n, can occur even in normal singleton pregnancies. Furthermore, it calls at tention to the necessity of ultrasonographic demonstration of ovaries even during late pregnancy.