Hyperreactio luteinalis: A clinical dilemma

Hyperreactio luteinalis (HL) is a pregnancy-associated benign condition with bilateral, rarely unilateral, ovarian enlargement caused by the presence of multiple cystic follicles secondary to β-human chorionic gonadotropin stimulation. Here, we report the case of a 24-year-old second gravida with a singleton pregnancy, with pregnancy-induced hypertension, who presented to the casualty with the chief complaints of headache and dizziness. The patient was later referred to the department of obstetrics and gynecology for further evaluation. On ultrasonography, a single live intrauterine pregnancy of 21-week gestation and bilateral enlarged cystic ovaries were revealed. With a clinical suspicion of ovarian tumor, bilateral oophorectomy was done, and the specimens were sent for histopathological study. On microscopy, the sections showed ovaries with numerous theca lutein cysts with hyperplasia and luteinization of the theca cells. Thus, surgical treatment is required for most of these patients. HL does not require any specific treatment except observation, unless complications occur.