Publication:

Differential diagnosis of bilateral ovarian masses during pregnancy, and their hormonal effect

Rapidly enlarging bilateral ovarian cystic masses can be confused with malignant entities. When this happens during pregnancy, benign transient reactivity can present a similar clinical course. Here we describe a 33-year-old woman with hyperreactio luteinalis or multiple gestational theca lutein cysts whose ovaries drastically changed in size peripartum, with concordant changes in human chorionic gonadotropin, thyroid function, and testosterone levels. Management was conservative and the cystic masses spontaneously remitted postpartum. Present work suggested that evaluating the character of the cysts by magnetic resonance imaging and serial assessments of their size and the patient’s hormonal levels may assist in diagnosis. Conservative management could be successfully applied in a carefully chosen subset of patients to avoid unnecessary invasive procedures.