Lutein Cysts

There are two types of lutein cysts: Corpus luteum cysts and theca lutein cysts.

Corpus Luteum Cyst

The corpus luteum cyst is an enlarged and longer living, but otherwise normal, corpus luteum. It can produce progesterone for weeks longer than normal. Signs/symptoms: Unilateral tenderness + amenorrhea Diagnosis: History and physical/pelvic exam (once ectopic pregnancy has been ruled out), sonogram

Treatment (only if symptomatic): Analgesics, oral contraceptives, laparot-omy/scopy if ruptured

Corpus hemorragicum is formed when there is hemorrhage into a corpus luteum cyst. If this ruptures, the patient will present with acute pain +/- bleeding symptoms (i.e., syncope, orthostatic changes).

Theca Lutein Cyst

Increased levels of human chorionic gonadotropin (hCG) can cause follicular overstimulation and lead to theca lutein cysts, which are often multiple and bilateral.

Conditions that cause elevated hCG levels:

■ Gestational trophoblastic disease (molar pregnancy)

■ Polycystic ovarian disease

■ Ovulation-inducing agents (clomiphene or hCG)

■ Multiple gestation:

Signs/symptoms: Signs and symptoms are usually due to the accompanying condition that causes the elevated hCG. Diagnostic finding: Elevated hCG levels

Treatment: One must treat the underlying condition; theca lutein cyst will resolve once hCG levels come down.

Pregnancy test must be performed to rule out ectopic pregnancy!

Amenorrhea is due to prolonged progesterone production.

LEIOMYOMAS (FIBROIDS)

Leiomyomas are localized, benign, smooth muscle tumors of the uterus. They are hormonally responsive and therefore become bigger and smaller corresponding to the menstrual cycle.

Epidemiology

Leiomyomas are found in 25 to 33% of reproductive-age women and in up to 50% of black women.

They are almost always multiple.

They are the most common indication for hysterectomy.

Sequelae

Changes in uterine fibroids over time (i.e., postmenopausal) include:

■ Hyaline degeneration

■ Calcification

■ Red degeneration (painful interstitial hemorrhage, often with pregnancy)

■ Cystic degeneration—may rupture into adjacent cavities

Uterine Locations of Leiomyomas

Submucous—just below endometrium; tend to bleed Intramural—within the uterine wall Subserous—just below the serosa/peritoneum

Extremely rarely do leiomyomas progress to malignancy (leiomyosarcoma).

Leiomyomas are most commonly of the subserous type.

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Responses

  • juhana
    Is lutin in amniotic fluid?
    7 years ago
  • carmela
    Are thecalutein cyst follicular?
    23 days ago
  • LEA
    Can theca lutein cyst be unilateral?
    12 days ago

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