Corpus luteum cyst

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Corpus luteum cyst
Corpus luteum cyst with bleeding.jpg
Corpus luteum cyst with bleeding. Fresh blood is anechoic (black). A protrusion of coagulated blood (lighter in color) can also be seen in the top of the cyst.
Specialty Gynaecology

A corpus luteum cyst or luteal cyst is a type of ovarian cyst which may rupture about the time of menstruation, and take up to three months to disappear entirely. A corpus luteum cyst does not often occur in women over the age of 50, because eggs are no longer being released after menopause. Corpus luteum cysts may contain blood and other fluids. The physical shape of a corpus luteum cyst may appear as an enlargement of the ovary itself, rather than a distinct mass-like growth on the surface of the ovary.

Contents

Signs and symptoms

Corpus luteum cysts are a normal part of the menstrual cycle. They can, however, grow to almost 10 cm (3.9 in) in diameter and have the potential to bleed into themselves or twist the ovary, causing pelvic or abdominal pain. It is possible the cyst may rupture, causing internal bleeding and pain. This pain typically disappears within a few days of the rupture. If the corpus luteum becomes large it may cause ovarian torsion, where the ovary twists and blood flow is cut off. Ovarian torsion is rare and is accompanied by severe pain.

Pathophysiology

Gross pathology of a corpus luteum cyst with bleeding Gross pathology of a corpus luteum cyst with bleeding.jpg
Gross pathology of a corpus luteum cyst with bleeding
Histopathology of a corpus luteum cyst, H&E stain, low magnification, showing a convoluted layer of mainly granulosa lutein cells, surrounding a fibrous to hemorrhagic center. Histopathology of a corpus luteum cyst, low magnification.jpg
Histopathology of a corpus luteum cyst, H&E stain, low magnification, showing a convoluted layer of mainly granulosa lutein cells, surrounding a fibrous to hemorrhagic center.

This type of functional cyst occurs after an egg has been released from a follicle. The follicle then becomes a secretory gland that is known as the corpus luteum. The ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. If a pregnancy doesn't occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood, causing the corpus luteum to expand into a cyst, and stay in the ovary. Usually, this cyst is on only one side, and does not produce any symptoms. [1] [2]

In women of reproductive age, cysts with a diameter of less than 5 cm (2.0 in) are common, clinically inconsequential, and almost always a physiological condition rather than cancer or another medical condition. [3] In postmenopausal women the threshold for concern is 1 cm (0.39 in). [3] Although ovarian cancer may be cystic, it does not arise from benign corpus luteum cysts. [3] Medical specialty professional organizations recommend no follow-up imaging for cysts which are considered clinically inconsequential. [3]

A ruptured corpus luteum can cause hemoperitoneum with abdominal pain, and is a common condition in women of reproductive age. It may be confused with ectopic pregnancy. [4]

Interaction with medication

The fertility drug clomiphene citrate (Clomid, Serophene), used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation. These cysts do not prevent or threaten a resulting pregnancy. [5] [6] Women on birth control pills usually do not form these cysts; in fact, preventing these cysts is one way birth control pills work. [7] In contrast, the progesterone-only pill can cause increased frequency of these cysts.

Related Research Articles

<span class="mw-page-title-main">Ovary</span> Female reproductive organ that produces egg cells

The ovary is a gonad in the female reproductive system that produces ova. When an ovum is released, this travels through the fallopian tube/oviduct into the uterus. There is an ovary found on the left and the right side of the body. The ovaries also secrete hormones that play a role in the menstrual cycle and fertility. The ovary progresses through many stages beginning in the prenatal period through menopause. It is also an endocrine gland because of the various hormones that it secretes.

<span class="mw-page-title-main">Polycystic ovary syndrome</span> Set of symptoms caused by abnormal hormones in females

Polycystic ovary syndrome, or polycystic ovarian syndrome (PCOS), is the most common endocrine disorder in women of reproductive age. The syndrome is named after cysts which form on the ovaries of some people with this condition, though this is not a universal symptom, and not the underlying cause of the disorder.

<span class="mw-page-title-main">Menstrual cycle</span> Natural changes in the human female reproductive system

The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eggs and the cyclic release of estrogen and progesterone. The uterine cycle governs the preparation and maintenance of the lining of the uterus (womb) to receive an embryo. These cycles are concurrent and coordinated, normally last between 21 and 35 days, with a median length of 28 days, and continue for about 30–45 years.

<span class="mw-page-title-main">Ovulation</span> Release of egg cells from the ovaries

Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm. In addition, the uterine lining (endometrium) is thickened to be able to receive a fertilized egg. If no conception occurs, the uterine lining as well as the egg will be shed during menstruation.

<span class="mw-page-title-main">Ovarian cyst</span> Fluid-filled sac in the ovary

An ovarian cyst is a fluid-filled sac within the ovary. They usually cause no symptoms, but occasionally they may produce bloating, lower abdominal pain, or lower back pain. The majority of cysts are harmless. If the cyst either breaks open or causes twisting of the ovary, it may cause severe pain. This may result in vomiting or feeling faint, and even cause headaches.

<span class="mw-page-title-main">Corpus luteum</span> Temporary endocrine structure in ovaries

The corpus luteum is a temporary endocrine structure in female ovaries involved in the production of relatively high levels of progesterone, and moderate levels of estradiol, and inhibin A. It is the remains of the ovarian follicle that has released a mature ovum during a previous ovulation.

<span class="mw-page-title-main">Ovarian follicle</span> Structure containing a single egg cell

An ovarian follicle is a roughly spheroid cellular aggregation set found in the ovaries. It secretes hormones that influence stages of the menstrual cycle. At the time of puberty, women have approximately 200,000 to 300,000 follicles, each with the potential to release an egg cell (ovum) at ovulation for fertilization. These eggs are developed once every menstrual cycle with around 450–500 being ovulated during a woman's reproductive lifetime.

Ovarian hyperstimulation syndrome (OHSS) is a medical condition that can occur in some women who take fertility medication to stimulate egg growth, and in other women in very rare cases. Most cases are mild, but rarely the condition is severe and can lead to serious illness or death.

An anovulatory cycle is a menstrual cycle characterised by the absence of ovulation and a luteal phase. It may also vary in duration from a regular menstrual cycle.

<span class="mw-page-title-main">Gynecologic ultrasonography</span> Application of medical ultrasonography to the female pelvic organs

Gynecologic ultrasonography or gynecologic sonography refers to the application of medical ultrasonography to the female pelvic organs as well as the bladder, the adnexa, and the recto-uterine pouch. The procedure may lead to other medically relevant findings in the pelvis.This technique is useful to detect myomas or mullerian malformations.

<span class="mw-page-title-main">Folliculogenesis</span> Process of maturation of primordial follicles

In biology, folliculogenesis is the maturation of the ovarian follicle, a densely packed shell of somatic cells that contains an immature oocyte. Folliculogenesis describes the progression of a number of small primordial follicles into large preovulatory follicles that occurs in part during the menstrual cycle.

<span class="mw-page-title-main">Luteal phase</span> The latter part of the menstrual cycle associated with ovulation and an increase in progesterone

The menstrual cycle is on average 28 days in length. It begins with menses during the follicular phase, followed by ovulation and ending with the luteal phase. Unlike the follicular phase which can vary in length among individuals, the luteal phase is typically fixed at approximately 14 days and is characterized by changes to hormone levels, such as an increase in progesterone and estrogen levels, decrease in gonadotropins such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), changes to the endometrial lining to promote implantation of the fertilized egg, and development of the corpus luteum. In the absence of fertilization by sperm, the corpus luteum degenerates leading to a decrease in progesterone and estrogen, an increase in FSH and LH, and shedding of the endometrial lining (menses) to begin the menstrual cycle again.

<span class="mw-page-title-main">Follicular atresia</span>

Follicular atresia refers to the process in which a follicle fails to develop, thus preventing it from ovulating and releasing an egg. It is a normal, naturally occurring progression that occurs as mammalian ovaries age. Approximately 1% of mammalian follicles in ovaries undergo ovulation and the remaining 99% of follicles go through follicular atresia as they cycle through the growth phases. In summary, follicular atresia is a process that leads to the follicular loss and loss of oocytes, and any disturbance or loss of functionality of this process can lead to many other conditions.

<span class="mw-page-title-main">Adnexal mass</span> Medical condition

An adnexal mass is a lump in the tissue of the adnexa of the uterus. Adnexal masses can be benign (noncancerous) or malignant (cancerous), and they can be categorized as simple or complex.

<span class="mw-page-title-main">Ovarian torsion</span> Medical condition

Ovarian torsion (OT) or adnexal torsion is an abnormal condition where an ovary twists on its attachment to other structures, such that blood flow is decreased. Symptoms typically include pelvic pain on one side. While classically the pain is sudden in onset, this is not always the case. Other symptoms may include nausea. Complications may include infection, bleeding, or infertility.

Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary. Typically the egg cell is not released or picked up at ovulation, but fertilized within the ovary where the pregnancy implants. Such a pregnancy usually does not proceed past the first four weeks of pregnancy. An untreated ovarian pregnancy causes potentially fatal intra-abdominal bleeding and thus may become a medical emergency.

Theca lutein cyst is a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. These cysts result from exaggerated physiological stimulation due to elevated levels of beta-human chorionic gonadotropin (beta-hCG) or hypersensitivity to beta-hCG. On ultrasound and MRI, theca lutein cysts appear in multiples on ovaries that are enlarged.

Ovarian apoplexy is a sudden rupture in the ovary, commonly at the site of a cyst, accompanied by hemorrhage in the ovarian tissue and/or intraperitoneal bleeding.

<span class="mw-page-title-main">Fertility testing</span>

Fertility testing is the process by which fertility is assessed, both generally and also to find the "fertile window" in the menstrual cycle. General health affects fertility, and STI testing is an important related field.

<span class="mw-page-title-main">Paraovarian cyst</span> Medical condition

Paraovarian cysts or paratubal cysts are epithelium-lined fluid-filled cysts in the adnexa adjacent to the fallopian tube and ovary. The terms are used interchangeably, and depend on the location of the cyst.

References

  1. "Ovarian Cysts: What You Need to Know about an Ovarian Cyst and PCOS".
  2. "Corpus luteum cyst". Uni. Utah: Knowledge Weavers: Human Reproduction.
  3. 1 2 3 4 American College of Radiology, "Five Things Physicians and Patients Should Question" (PDF), Choosing Wisely: an initiative of the ABIM Foundation , American College of Radiology, archived from the original (PDF) on April 16, 2012, retrieved August 17, 2012, citing
  4. Bauman, Renato; Horvat, Gordana (December 2018). "MANAGEMENT OF RUPTURED CORPUS LUTEUM WITH HEMOPERITONEUM IN EARLY PREGNANCY – A CASE REPORT". Acta Clinica Croatica. 57 (4): 785–788. doi:10.20471/acc.2018.57.04.24. PMC   6544092 . PMID   31168219.
  5. "Ovarian cysts: Causes". Mayo Clinic.
  6. "Corpus luteum cyst". Mayo Clinic.
  7. Hill DA. "Photos of the Ovaries". Women's Health Information. Archived from the original on March 21, 2007.