Hyperreactio luteinalis – two accidental findings during cesarean section

Authors: A. Schwandner 1;  M. Zámečník 2;  P. Kaščák 1
Authors‘ workplace: Gynekologicko-pôrodnícka klinika, Fakultná nemocnica Trenčín, prednosta a primár MUDr. P. Kaščák, PhD. 1;  Medirex Group Academy n. o., Bratislava, riaditeľ MUDr. P. Janega 2
Published in: Ceska Gynekol 2019; 84(6): 439-442
Category: Case Report


Objective: To present two cases of patients with hyper­reactio luteinalis at the cesarean section.

Design: Case report.

Setting: Department of Obstetrics and Gynaecology, Hospital Trenčín; Medirex Group Academy n.o., Bratislava.

Case report: We report two cases of women with preeclampsia who we diagnosed with bilateral multi-cystic ovarian enlargement by chance during cesarean section. At both of them the level of human chorionic gonadotropin was above normal, one of the patients had medical history of ovarian serous borderline tumor and this pregnancy was multiple after in vitro fertilization and embryo transfer. Adnexectomy, resection of ovaries and biopsy were carried out. Histologically hyperreactio luteinalis was confirmed in both patients.

Conclusion: We discuss the necessity of surgical treat­ment, the authors want to emphasize the need for proper preoperative diagnosis and indication of conservative management of patients with hyperreactio luteinalis.


hyperreactio luteinalis – multicystic enlargement of ovaries – human chorionic gonadotropin


1. Abe, T., Ono, S., Igarashi, M., et al. Conservative management of hyperreactio luteinalis: a case report. J Nippon Med Sch, 2011, 78, p. 241–245.

2. Atis, A., Aydin, Y., Ozdemir, G., Goker, N. Hyperreactio luteinalis with preeclampsia. J Emerg Trauma Shock, 2010, 3, 3, p. 298.

3. Cavoretto, P., Giorgione, V., Sigismondi, C., et al. Hyperreactio luteinalis: timely diagnosis minimizes the risk of oophorectomy and alerts clinicians to the associated risk of placental insufficiency. Eur J Obstet Gynecol Reprod Biol, 2014, 176, p. 10–16.

4. Chaverri, AP., Solis, BEA., Paulín, FD., Cárdenas, JEG. Hyperreactio luteinalis and hypothyroidism: A case report. Case Rep Womens Health, 2018, 21, e00094, doi: 10.1016/j.crwh.2018.e00094.

5. Faden, M., Salehi, AH., Simon, J., et al. Hyperreactio luteinalis in association with multiple foetal malformations – a consequence of supra-physiological hCG? Case Rep Perinat Med, 2013, 3, 1, p. 5–9.

6. Foulk, RA., Martin, MC., Jerkins, GL., Laros, RK. Hyperreactio luteinalis differentiated from severe ovarian hyperstimulation syndrome in a spontaneously conceived pregnancy. Am J Obstet Gynecol, 1997, 176, 6, p. 1300–1304.

7. Grochal, F., Turner, CD., Chern, AL., et al. Sonographic detection of the ovarian hyperreactio luteinalis in pregnancy. J Diagn Med Sonogr, 2008, 24, 6, p. 369–373.

8. Lynn, KN., Steinkeler, JA., Wilkins-Haug, LE., Benson, CB. Hyperreactio luteinalis (enlarged ovaries) during the second and third trimesters of pregnancy: common clinical associations. J Ultrasound Med, 2013, 32, 7, p. 1285–1289.

9. Malinowski, AK., Sen, J., Sermer, M. Hyperreactio luteinalis: maternal and fetal effects. J Obstet Gynaecol Can, 2015, 37, 8, p. 715–723.

10. Morken, NH., Friberg-Otterstad, UM., Kahn, JA. Hyperreactio luteinalis presented as an acute abdomen. Acta Obstet Gynecol Scand, 2007, 86, p. 104–106.

11. Schnorr, JA. Jr. Hyperreactio luteinalis associated with pregnancy: a case report and review of the literature. Am J Perinatol, 1996, 13, 2, p. 95–97.

12. Simsek, Y., Celen, S., Ustun, Y., et al. Severe preeclampsia and fetal virilization in a spontaneous singleton pregnancy complicated by hyperreactio luteinalis. Eur Rev Med Pharmacol Sci, 2012, 16, p. 118–121.

13. Skandhan, AK., Ravi, V. Hyperreactio luteinalis: an often mistaken diagnosis. Indian J Radiol Imaging, 2014, 24, p. 84–86.

14. Takeuchi, M., Matsuzaki, K. Magnetic resonance manifestations of hyperreactio luteinalis. J Comput Assist Tomogr, 2011, 35, p. 343–346.

15. van Holsbeke, C., Amant, F., Veldman, J., et al. Hyperreactio luteinalis in a spontaneously conceived singleton pregnancy. Ultrasound Obstet Gynecol, 2009, 33, p. 371–373.

16. Wajda, KJ., Lucas, JG., Marsh, WL. Jr. Hyperreactio luteinalis. Benign disorder masquerading as an ovarian neoplasm. Arch Pathol Lab Med, 1989, 113, p. 921–925.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 6

2019 Issue 6

Most read in this issue
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account