Luteinized Follicle Cyst Of Pregnancy Research Articles

Large Solitary Luteinized Follicle Cyst of Pregnancy and Puerperium Newly Developed in the Postpartum

Ovarian tumors and tumor-like masses in the gravidpuerperium period are uncommon, with incidences...

Large Solitary Luteinized Follicle Cyst of Pregnancy and Puerperium: a Rare Post-partum Clinical Presentation

Abstract Introduction/Objective In literature, all large solitary luteinized follicular cysts of pregnancy and puerperium (LSLFCPP) recognized were removed before or during delivery. This would be the first case in literature describing the clinical behavior of the LSLFCPP in the post-partum period. Methods We herein report a rare case of 21-year-old G2P2 female who underwent a full-term uneventful spontaneous vaginal delivery (39w0d, APGARS 9,9) without removal of the undiagnosed LSLFCPP, which nearly doubled in size post-partum. Her past medical history was significant for treated syphilis and normal Pap Test of the cervix. Three months after delivery, the patient presented with LSLFCPP exhibiting mass effect (retroverted uterus, mild right-sided obstructive uropathy, compressed bladder and intermittent pain). The antepartum ultrasound showed 14 cm pelvic mass that had grown to 30 cm on CT scan, in largest dimension. Beta-hCG levels returned to pre- pregnancy levels. Treponema pallidum antibody, FTA-ABS and RPR were reactive. Alpha-fetoprotein, inhibin B, CA- 125, CEA, and CA 19-9 screen were unremarkable. The patient underwent exploratory laparotomy cyst removal with right salpingo-oophorectomy. Results Grossly, the tumor weighed 22 lbs with a diameter of 28 cm; excrescences were not noted. Intraoperative consultation revealed a unilocular benign cyst. Histologically, the cyst was not only lined by luteinized cells but nests of luteinized cells infiltrated the fibrous wall. These cells were positive for Inhibin A and calretinin. A rare mitotic figure was noted. A diagnosis of LSLFCPP was rendered. Conclusion High levels of gonadotropin in pregnancy are implicated in the pathogenesis of LSLFCPP; however, in our case, the cyst doubled in size three months after delivery with undetectable beta-hCG levels. This indicates that the pathogenesis of this cyst relies on more than beta-hCG stimulation. LSLFCPP is important to recognize because it can mimic a malignant proliferation on frozen section and can potentially compromise fetal viability with mass effect.

Large Multiloculated Luteinized Follicle Cyst of Pregnancy and Puerperium in a Patient with Bilateral Ovarian Cysts

We describe a case of large multiloculated luteinized follicle cyst of pregnancy and puerperium (LSLFCPP) in a 21-year-old female presenting with pelvic pain seven weeks after a normal spontaneous vaginal delivery. Imagining studies demonstrated a left 23cm and right 8 cm ovarian cysts and she underwent laparoscopic left salpingo-oophorectomy and right cystectomy. Microscopic examination of the left ovarian cyst revealed a benign luteinized follicle cyst of pregnancy and right sided simple benign cyst. Large luteinized follicle cyst of pregnancy and puerperium (LSLFCPP) is a rare benign entity that can mimic malignant processes of the ovary on imaging and on microscopic examination. It is important to recognize this condition during pregnancy and gestation as conservative management is the preferred treatment of choice.

Large solitary luteinized follicle cyst of pregnancy and puerperium: report of two cases

We describe two cases of large solitary luteinized follicle cyst of pregnancy and puerperium (LSLFCPP) with new clinicopathologic findings. The first case occurred in a 40-year old woman who was found to have a left ovarian mass during the third trimester of pregnancy. The patient delivered a full term healthy female infant via caesarean section. The ovarian mass was removed by oophorectomy. The specimen showed a unilocular, thin-walled, clear fluid filled cyst measuring 15 × 12 × 5 cm. Microscopically, the cyst was lined by single to multiple layers of luteinized cells with mainly small, round and regular nuclei and focally enlarged, bizarre, and hyperchromatic nuclei. Occasional mitotic figures were seen. The cyst wall showed marked edema and nests of luteinized cells that were morphologically similar to the cyst lining cells. Groups of lesional cells were surrounded by reticulin fibers. The patient has been healthy without disease after 7 years. The second patient was a 29-year old pregnant woman who was found to have a right ovarian cyst by ultrasound at 14-week gestation. She then presented with preterm labor at 33-week gestation and delivered a healthy female infant via caesarean section. A right salpingo-oophorectomy was performed. Gross inspection of the specimen revealed a unilocular, brown mucoid fluid filled cyst measuring 14 × 11 × 9 cm. The cyst surfaces were smooth, and the cyst wall exhibited marked edema. Microscopic examination showed features similar to the first case: cyst lined by luteinized cells with focal large nuclei, scattered nests of luteinized cells in the edematous fibrous wall, and reticulin fibers surrounding large nests of lesional cells. No mitoses, however, were identified in the second case. The patient has been well without disease 1 year after surgery. These two cases contribute to a better understanding of LSLFCPP. Our case in the 40-year old patient is the first to show mitotic figures in LSLFCPP and suggests that the presence of occasional mitoses should not exclude a diagnosis of LSLFCPP. The lesion in the second patient caused preterm labor. Nevertheless, absence of disease recurrence in our patients demonstrates a benign nature of LSLFCPP.

Solitary luteinized follicle cyst of pregnancy complicated with persistent postpartum vaginal bleeding: case report

Solitary luteinized follicle cyst a rare cause of ovarian enlargement during pregnancy and puerperium is a self-limited disease that can regress spontaneously after labor. The complications of the disease include ovarian torsion intracystic hemorrhage and rupture; endocrine disturbances have not been reported. Here we report a case of solitary luteinized follicle cyst of pregnancy which required surgical intervention owing to persistent postpartum vaginal bleeding. (excerpt)

Solitary luteinized follicle cyst of pregnancy and puerperium

We report a huge ovarian solitary luteinized follicle cyst (SLFC) that contained 17 liters of fluid. Computed tomography scan revealed a 32×32×20 cm right simple cystic ovarian mass without calcification or septation. The fluid was removed, and the collapsed unilocular cyst was examined pathologically. No solid or papillary areas were identified. The cyst wall lining was composed of multiple layers of luteinized cells of variable size and shape with abundant eosinophilic cytoplasm and focally enlarged, pleomorphic, and hyperchromatic nuclei. Nests of luteinized cells were embedded within the fibrous tissue of the cyst wall. These findings are characteristic of solitary luteinized follicle cyst of pregnancy. Even though less than 15 cysts of this kind have been recorded, one should consider this uncommon, benign, non-neoplastic cystic ovarian lesion in the differential diagnosis of other cystic ovarian lesions.

Large solitary luteinized follicle cyst of pregnancy and puerperium

A case of large solitary luteinized follicle cyst of pregnancy and the puerperium, arising in a 22 year old primipara, three months post partum, is presented with clinical and pathological details. This is a rare type of follicle cyst and has to be differentiated from a cystic neoplasm.

Tumor-Like Lesions of the Ovary Associated—with Pregnancy

Six nonneoplastic ovarian lesions (or alterations) are associated with pregnancy or the puerperium, each of which can simulate a neoplasm on clinical, gross, or microscopic examination. These lesions include pregnancy luteoma, hyperreactio luteinalis, large solitary luteinized follicle cyst of pregnancy and puerperium, intrafollicular granulosa cell proliferations, hilus cell hyperplasia, and ectopic decidua. Because these lesions involute spontaneously after termination of pregnancy or are adequately treated by a conservative surgical approach, unnecessarily radical operations can be avoided if the correct diagnosis is made by the pathologist.

Non-neoplastic Ovarian Cysts With Ectopic Pregnancy

Thirty non-neoplastic ovarian cysts, discovered at laparotomy in association with 27 cases of tubal ectopic pregnancy, were examined to document changes seen in early pregnancy and possibly to identify precursor lesions to the luteinized cysts of later pregnancy. The ages of the patients ranged from 16 to 40 years, and length of gestation varied between 5 and 11 weeks. Of the 30 cysts, 12 were corpus luteum cysts; 10 were called lutein cysts, nonspecific, and had a lining of luteinized cells of a single cell type; three cysts were luteinized follicles; four cysts were unlined or lined by a single layer of cells. The origin of these four was not obvious, and they were called "simple cysts." The last was a granulosa-theca lutein cyst. Corpus luteum cysts are assumed to arise from the corpus luteum, and simple cysts appear to arise from both corpus luteum cysts and other follicular structures. The nonspecific lutein cysts appeared to arise from structures other than the corpus luteum or corpus luteum cysts; these nonspecific lutein cysts may be precursors to the so-called large solitary luteinized follicle cyst of pregnancy.

Large Solitary Luteinized Follicle Cyst of Pregnancy and Puerperium. A Clinicopathological Analysis of Eight Cases

Department of Pathology, Harvard Medical School, and the James Homer Wright Laboratories of the Massachusetts General Hospital, Boston, Massachusetts; and Department of Pathology, Faculty of Medicine, University of British Columbia, and the Vancouver General Hospital, Vancouver, British Columbia, Canada

Large solitary luteinized follicle cyst of pregnancy and puerperium: A clinicopathological analysis of eight cases.

Eight cases of a rare type of ovarian cyst with distinctive clinical and pathologic features are reported. The patients presented with a palpable adnexal mass during pregnancy or the puerperium, or with a unilateral ovarian cyst during cesarean section at term. There were no associated endocrine disturbances. The cysts were large, solitary and unilocular and had a median diameter of 25 cm. On microscopical examination they were lined by luteinized cells that exhibited focal marked nuclear atypicality. All six patients who were followed postoperatively were alive and well at intervals of 5--68 months, suggesting that the cysts were luteinized follicle cysts related to the high gonadotropin levels of pregnancy rather than cystic neoplasms.