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Corpus luteal cyst

A corpus luteal (CL) cyst is a type of functional ovarian cyst which results when a corpus luteum fails to regress following the release of an ovum. When associated with pregnancy, it is the most common pelvic mass encountered within the 1st trimester 1.

Pathology

The natural history of a normal corpus luteum is to regress - by the end of the 1st trimester if pregnancy has occurred. If a corpus luteum fails to regress, and instead enlarges with or without haemorrhage, a corpus luteum cyst is formed. There is some overlap in the definitions of a corpus luteum cyst and a haemorrhagic corpus luteum 5.

Natural course

When associated with pregnancy, most corpus luteal cysts spontaenously involute at the end of the 2nd trimester.

Radiographic features

Ultrasound

They can have a range of sonographic appearances depending on the stage of evolution and age of the associated intracystic haemorrhage 3.

If the cyst has been present for some time with complicating haemorrhage, a fine internal lace like echo-pattern may be seen.

Colour Doppler interrogation show either no vascularity within the cyst or at times show low resistance blood flow around the cyst also known as hypervascular ''ring of fire''.

CT
  • low-attenuating (25HU) cyst, <3cm in diameter with thick, slightly irregular and iso- or hyper-dense walls 6 
  • free fluid is often associated 6
MRI

Often seen as a round or oval adenxal lesion

  • T1 - typically homogeneously hypo intense 1
  • T2 - typically hyper intense 1-2
  • T1 C+ (Gd) - intense wall enhancement may be seen 1

Complications

Differential diagnosis

It can be difficult to differentiate from a tubal ring in an ectopic pregnancy in some situations and correct clinical interpretation is often required.

See also

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