Abstract
Large, solitary, luteinized follicle cyst of pregnancy and the Puerperium is a rare type of ovarian cyst. The pathogenesis has been related to high gonadotropin levels of pregnancy. Supportive data based on relevant laboratory tests were not available in any previous case reports. The present report describes, for the first time, such a cyst from a 16-year-old Primigravida with both pertinent hormone levels prior to surgery and immuno-histochemical exploration of the lesion. The patient's hormonal profile of absent βHCG and suppressed pituitary gonadotropin levels failed to support a mechanism of abnormal hormonal stimulation as previously postulated. Nevertheless, the stromal hyperthecosis we observed appeared to indicate some degree of luteinizing hormone (LH) stimulation. In view of the low LH levels, such hyperthecosis may reflect a time lag between cause and effect. The results of immunohistochemical studies confirmed the granulosa derivation of the large luteal cells in the cyst wall. By expressing neurophysin, a carrier protein for oxytocin-vasopressin that does not occur in theca cells, these luteal cells reveal a stage of functional activity that is characteristic of the menstrual and early gestational corpus luteum.
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