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  • Title: The natural history of theca lutein cysts.
    Author: Montz FJ, Schlaerth JB, Morrow CP.
    Journal: Obstet Gynecol; 1988 Aug; 72(2):247-51. PubMed ID: 2455880.
    Abstract:
    The histories of 386 patients with untreated hydatidiform mole were reviewed to define the clinical aspects of accompanying theca lutein cysts. These cysts occurred in 102 patients (26.4%), with three patients experiencing cyst-related complications. Mean cyst size at diagnosis was 7.3 cm (3-20 cm), and did not correlate with post-molar trophoblastic disease development. Bilateralism occurred more often in patients developing post-molar trophoblastic disease. In patients with post-molar trophoblastic disease, 83% (45 of 54) experienced theca lutein cyst regression and 16.7% an increase in cyst size with falling beta-hCG titers. Post-molar trophoblastic disease developed in 44 patients. Theca lutein cyst growth occurred in 31.8% of the patients with beta-hCG plateau/rise and in 4.5% with falling titers. Disappearance of theca lutein cysts before diagnosis of post-molar trophoblastic disease occurred in 31.8%. Theca lutein cysts persisted in three patients for long periods (15-18 weeks) after beta-hCG regression. We conclude that theca lutein cysts commonly accompany hydatidiform mole and are associated with an increased risk of post-molar trophoblastic disease, a risk that is higher with cyst bilateralism or severe complications of hydatidiform mole. Theca lutein cysts uncommonly have serious complications; their clinical behavior does not depend entirely on changes in beta-hCG levels, as cysts may persist for long periods after beta-hCG regression.
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