Csapó Z, Szabó I, Tóth M, Dévényi N, Papp Z
Department of Obstetrics and Gynecology, Semmelweis University Medical School, Budapest, Hungary.
J Reprod Med. 1999 Jan;44(1):53-6.
Hyperreactio luteinalis rarely occurs in normal singleton pregnancy. About 50 such cases have been published. This case is noteworthy because it resulted in extremely enlarged ovaries and was accompanied by a hyperandrogenic state and high level of human chorionic gonadotropin.
A gravida was referred to our department because of large, bilateral, cystic ovaries diagnosed by ultrasonography in the 28th week of gestation. Markedly elevated levels of androgens and human chorionic gonadotropin were noted. During the following six weeks the ovarian masses enlarged, and the hyperandrogenic state worsened. Cesarean section and, because of a bleeding right adnexectomy, left ovarian resection were performed. Histology confirmed the presumed diagnosis of hyperreactio luteinalis. The placenta was unremarkable. Seventeen weeks after surgery the hormone levels were normal.
Our case suggests the possibility that in certain cases of hyperreactio luteinalis, an idiopathic elevation of human chorionic gonadotropin, can occur even in normal singleton pregnancies. Furthermore, it calls attention to the necessity of ultrasonographic demonstration of ovaries even during late pregnancy.
黄素化囊肿在正常单胎妊娠中很少见。已发表约50例此类病例。该病例值得注意，因为它导致卵巢极度增大，并伴有高雄激素状态和高水平的人绒毛膜促性腺激素。
一名孕妇因在妊娠第28周超声检查发现双侧卵巢巨大囊性肿物而转诊至我科。发现雄激素和人绒毛膜促性腺激素水平明显升高。在接下来的六周内，卵巢肿物增大，高雄激素状态恶化。行剖宫产术，因右侧附件出血行右侧附件切除术，左侧卵巢切除术。组织学证实了黄素化囊肿的推测诊断。胎盘无异常。术后17周激素水平正常。
我们的病例提示，在某些黄素化囊肿病例中，即使在正常单胎妊娠中也可能出现人绒毛膜促性腺激素的特发性升高。此外，它提醒人们即使在妊娠晚期也有必要通过超声检查显示卵巢。
