Presentation
Two-month history of amenorrhea.
Patient Data
Both ovaries are grossly enlarged. Multiple spherical anechoic cysts are seen in both ovaries (right > left), with septa within. The enlarged uterus is filled with an echogenic mass containing multiple vesicles.
Case Discussion
Bilateral ovarian enlargement in the present case was caused by large, multiple cysts in both ovaries. Beta-hCG levels were markedly raised. In this case, the culprit was identified as a complete hydatidiform mole.
By appearance and size alone, large cystic ovaries may appear neoplastic. However, theca lutein cyst is a functional ovarian cyst filled with clear, straw-colored fluid resulting from physiological hyperstimulation by elevated levels of beta-human chorionic gonadotropin (beta-hCG) or hypersensitivity to beta-hCG 1. Other conditions such as choriocarcinoma, multiple gestation, diabetes mellitus, and fertility treatment may also be associated with theca lutein cysts 2.
Theca lutein cysts generally resolve spontaneously after the treatment of the underlying condition. Rarely, some complications may occur, like ovarian torsion, hemorrhage, or hyperthyroidism.