Luteoma of Pregnancy Presenting with Severe Maternal Virilisation: A Case Report

Abstract

Luteoma of pregnancy is a rare, benign condition characterized by a tumor-like mass of the ovary that emerges during pregnancy and regresses spontaneously after delivery. It is usually asymptomatic and the diagnosis is generally incidental. Luteoma arises from the proliferation of luteinised cell under the influence of β-hCG and can be hormonally active, with production of androgens resulting in maternal and fetal hirsutism and virilisation. We report a case of a 25-year-old primigravida who presented at 28 weeks of gestation with virilisation symptoms. Serum androgen levels were seven-hundred-fold higher than normal. A diagnosis of pregnancy luteoma was made at the time of caesarean section. The ovarian mass, serum androgen levels, and the condition of the patient improved after delivery.

Hirsutism Caused by Pregnancy Luteoma in a Low-Resource Setting: A Case Report and Literature Review

“…An occurrence preponderance has been noted among the Afro-Caribbean around the ages of 30 and 40 years old and those with preexisting PCOS [ 11 ]. PCOS contributes to high β -hCG hormone levels favoring the proliferation of pregnancy luteoma [ 2 , 26 ]. These findings on age of occurrence are consistent with our case report.…”

“…The diagnosis of pregnancy luteoma requires a high index of suspicion; once you suspect it based on the above-mentioned signs, perform detailed obstetric ultrasonography to visualize the size of the ovary. In addition, supportive investigations like hormonal assays should also be done to rule out other ovarian neoplasms [ 29 ].The management of pregnancy luteoma is case dependent ( Table 1 ), for instance, cases presenting with severe virilization symptoms [ 2 ], pressure symptoms, or torsion will require prompt surgery while the asymptomatic cases require conservative managements with regular follow-up [ 30 ] as they usually regress spontaneously following delivery. Despite lacking hormonal assays in this case, spontaneous regression of hyperandrogenemia is the natural course of pregnancy luteoma [ 5 ].…”

“…Our review included studies obtained from reference to published articles and literature search engines: PubMed or Google Scholar, using the terms “pregnancy luteoma.” A total of 205 case reports were reviewed from PubMed and 2,100 from Google Scholar. We identified and summarized 24 articles reporting 25 cases of pregnancy luteoma [ 2 , 4 – 25 ] ( Table 1 ).…”

“…Pregnancy luteoma is a rare nonneoplastic tumor-like lesion of the ovary that has an increased androgenic activity during pregnancy [1]. It is associated with varied symptoms, for instance, hirsutism, acne, deepening of voice, and virilization symptoms [2]. The first occurrence was reported by Sternberg and Barclay in 1966, and to date, very few cases have been documented in the literature [3].…”

Unusual Course of Acne Conglobata as a Skin Manifestation due to Bilateral Luteoma of Pregnancy

“…Approximately 25% to 60% of women with PL have androgen hypersecretion 2 3 . Androgen concentrations should normalize in approximately 2 weeks, while clinical symptoms should resolve 3 months after labor or tumor resection 4 . In our case severe acne conglobata lesions persisted three months after delivery.…”