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Acute abdominal distension.
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Sonography revealed enlarged ovaries with multiple cysts within and increased echogenic stroma. No focal lesion was detected in either ovary. Ascites and minimal pleural effusion were also found. There was no history of infertility treatment.
Considering the imaging findings and the acute clinical condition a possible diagnosis of spontaneous ovarian hyperstimulation was given. The gynecologists considered an alternate diagnosis of bilateral ovarian tumors. The alpha feto protein, HCG, LDH, CA-125 levels were normal. Patient underwent laparotomy with a high clinical suspicion of malignancy. Ovarian biopsy revealed edema and stromal hyperplasia. This condition is also called ovarian hyperthecosis when luteinised theca cells were seen in the stroma.
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