Textbooks describe lutein cystic cystic enlargement of the ovaries are frequently found in associaton with hydatidiform mole and choriocarcinoma or rarely in adenoma of tithe pituitary gland.
Literatures of last 15 Srears report the calutein cysts of the ovaries are found occasion in association with abnormal pregnancy and even with normal pregnancy.
This report is of a patient who complained of a large rapid growing ovarian mass at 8 week´s gestation, which was lined by luteinized theca interna and granulosa cells.
Case Report
K. Y. S., a 34 year-old, gravida 12, para 2, abortus 10, being 9 artificially induced and one spontaneous, was admitted to our hospital on January 3, 1970 with a complaint of moderate lower abdominal pain of 10 days´ duration. The last delivery was 6 years ago. The LMP had begun on October 26, 1969. The only relevant previous history was that of numerous uterine curettages for artificial and spontaneous abortions. The patient was examined on November 15,1969 and no adnexal tumor, was found in our hospital. The patient was pale, febrile of 37.3´C. and normotensive, with normal vital signs. The uterus was enlarged to 8 weeks gestational size at the, left lower abdomen; and double fist sized doughy slightly tender mass was palpated in the right adnexa extending to the right lower abdomen.
A Gravindex pregnancy test was positive on admisson. The hemoglobin 9.Ogm/100ml. and the hematocrit was 30%. The WBC 8, 500/cu mm with neutrophils with"Jobulated nuclei 77%, band cell neutrophils 3%, mononuclears 5%, lymphocytes 15%, and the blood, group was Type B. Urinalysis was within normal limits. The chest X-ray was normal.
An infusion of whole blood was started and the patient was operated upon. The right ovarian mass measured approximately 18 X 15 X 15cm, replaced by a thin walled cystic mass. The uterus was sinsitrodeviated and . enlarged to that of gestation compatible with dates of 8 weeks´ gestational size (10 weeks from the LMP).
The left ovary was, enlarged approximately 6X6X5cm with multiple yellowish cysts of varying size. The ovarian cysts were adherent to intestines and ruptured during operation with massive hemorrhage, therefore the partial resection of the ovarian cyst was done. Histologic sections of the right ovarian mass showed cyst wall lined by lutein zed theca interna cells (Fig. 1 and 2).
The patient´s post-operative course was uneventful. Three weeks later the patient presented dark spotting with abdominal distress. Evacuation from the uterus was performed. Sections of the placenta showed normal placental histology.
|