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Corpus luteal cyst

Dr Abhilash Sandhyala and Dr Yuranga Weerakkody et al.

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 1^sttrimester ¹.

Pathology

The natural history of a normal corpus luteum is to regress - by the end of the 1^st 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 vs haemorrhagic corpus luteum ⁵.

Natural course

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

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

haemorrhage - haemorrhagic corpus luteal cyst

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.