Rupture of Bilateral Theca Lutein Cysts During Pregnancy: A Case Report

Abstract

Hyperreactio luteinalis is a rare condition characterized by the presence of bilateral theca lutein cysts, which occur rarely in a singleton normal pregnancy. Bilateral multicystic ovarian enlargement occurs due to elevated beta-human chorionic gonadotropin. We present a rare case of a 23-year-old primigravida in her tenth week of gestation, presenting with an acute abdomen, with increasing abdominal girth, diagnosed with a rupture of theca lutein cyst, and posted for laparotomy. Theca lutein cyst doesn’t affect the course of pregnancy and has a spontaneous regression after delivery. Our case is different due to the occurrence of cysts in a singleton pregnancy and the rupture of these cysts during pregnancy. Unless complicated by torsion, rupture, or hemorrhage, most theca lutein cysts are managed conservatively.

Hyperreactio luteinalis and follicle-stimulating hormone receptor gene activation mutations: A case report

“…Bilateral ovarian polycystic echogenicity occurs after pregnancy without pelvic or abdominal fluid, and the “radial” appearance within the cystic echogenicity of both ovaries is a characteristic manifestation of ovarian luteal hyperreactivity. The differential diagnosis can be made by combining clinical symptoms and biochemical tests, and some patients have abnormal thyroid-stimulating hormone and testosterone levels [ 3 , 4 ]. Follicle-stimulating hormone receptor (FSHR)-related genetic testing is recommended in patients with normal biochemical parameters but recurrent luteal hyperreactivity after pregnancy.…”

“…It can easily be mistaken for a tumor, and unnecessary surgery may be performed [ 2 ]. Previous literature on ovarian hyperresponsiveness is usually found in case reports, and some studies have linked it to primary hypothyroidism and elevated testosterone [ 3 , 4 ]. Elevated thyroid-stimulating hormone levels may contribute to the development of HL through cross-reactivity with human chorionic gonadotropin and follicle-stimulating hormone receptors.…”