Hyperreactio Luteinalis : Presentation

Clinical Presentation: Hyperreactio luteinalis is usually asymptomatic and may be detected at cesarean section or during puerperium. Some patients present with lower abdominal pain and bilateral adnexal masses during pregnancy. Rare cases undergo complications (intracystic hemorrhage, torsion, rupture) and present with acute abdominal pain. Fatalities have resulted from massive hemoperitoneum following rupture. Elevated plasma testosterone levels associated with virilization are seen in 25% of patients; however, there is no virilization of the female fetus.

The image shows thin walled follicular cysts lined by luteinized theca interna and granulosa cells. The interfollicular stroma is edematous and may also contain luteinized stromal cells.