Abstract:

Pregnancy luteoma (PL) is an ovarian tumor-like lesion with very low incidence, which mostly occurs in the second and the third trimester. The etiology and pathogenesis of PL are unclear, and clinical manifestations vary greatly. There are no specific imaging features and serological markers. The misdiagnosis and mistreatment are prone to occur due to insufficient understanding and treatment experience. We report a case of PL, in which the patient presented with hyperandrogenism, hydrothorax and ascites, and elevated serum alpha-fetoprotein (AFP) and carbohydrate antigen 125 (CA125). Imaging suggested bilateral large ovarian masses. The possibility of malignant ovarian tumor cannot be ruled out, and surgical treatment was recommended. The patient refused to undergo surgery. After reviewing relevant literatures, we realized the possibility of PL. Conservative treatment and clinical observation were adopted. After a one-month follow-up, the symptoms disappeared, liver function returned to normal, and serum AFP and CA125 normal. Gynecological color ultrasound showed no abnormalities in the uterus and bilateral adnexa, ruling out ovarian malignancy. The follow-up was continued for 22 months with no abnormal conditions, and clinical outcome was satisfactory. Eventually, the bilateral PL was diagnosed, and the surgery as for this case was successfully avoided.

Key words: Pregnancy, Luteoma, Ovarian neoplasms, Testosterone, CA-125 antigen, Diagnostic errors