Abstract

Theca lutein cyst is a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. To be classified a functional cyst, the mass must reach a diameter of at least three centimeters.

These cysts result from exaggerated physiological stimulation (hyperreactio luteinalis) and are usually associated with markedly elevated levels of beta-human chorionic gonadotropin (beta-hCG). They are thus associated with gestational trophoblastic disease (molar pregnancy), diabetes mellitus, alloimmunisation to Rh-D, and multiple gestations. They have rarely been associated with chronic kidney disease (secondary to reduced hCG clearance) and hyperthyroidism (given the structural homology with TSH). These cysts resolve after pregnancy. Rarely, when the theca-lutein cysts are stimulated by gonadotropins, massive ascites can result. In most cases however, abdominal symptoms are minimal and restricted to peritoneal irritation from cyst hemorrhage. Surgical intervention may be required to remove ruptured or infarcted tissue.

Women who smoke have a twofold increase for functional cysts.