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Theca lutein cysts are rare, benign lesions responsible for gross cystic enlargement of both ovaries during pregnancy. This condition is also termed hyperreactio luteinalis. Elevated human chorionic gonadotropin (hCG) levels or states of hCG hypersensitivity seem to promote these changes, which in up to 30% of patients produce clinical signs of hyp...
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Context 1
... serum dehydroepiandrosterone sulfate was within the normal range. The serum total hCG level was still elevated (23 mlU/mL), with suppressed levels of luteinizing hormone (LH; < 0.1 mIU/mL) and folli- (Table 1). Various tumor markers, including carcinoembryonic antigen, α-fetoprotein, cancer antigen (CA) 125, and CA 19-9, were within the respective normal ranges. ...Context 2
... 3 months of treatment, serum androgen levels had declined but remained elevated: testosterone, 3.14 ng/mL; free testosterone, 3.62 pg/mL; 17-hydroxyprogesterone, 11.67 ng/mL; and FAI, 5.2. Serum total hCG was also much lower (6 mlU/mL) (Table 1), with unchanged ovarian dimensions on ultrasound. Having curbed the virilization and reduced androgen levels, we discontinued the anti-androgenic regimen. ...Context 3
... months after delivery, serum testosterone, free testosterone, and 17-hydroxy-progesterone levels further declined to 0.942 ng/mL, 2.31 pg/mL, and 5.16 ng/mL, respectively. The serum total hCG level was lower as well (2 mlU/mL) ( Table 1). Virilization did not progress after medication withdrawal, both ovaries again appearing unchanged. ...Context 4
... months after delivery, serum testosterone, free testosterone, and 17-hydroxyprogesterone levels had normalized (0.084 ng/mL, 0.89 pg/mL, and 2.16 ng/mL, respectively), and the serum total hCG level was < 0.2 mlU/mL. The cystic ovaries had finally regressed (right: 11.2 × 10.7 cm; left: 4.1 × 4.1 cm), albeit more so on the left (Table 1). ...Citations
... Most theca lutein cysts are asymptomatic, but maternal virilization, hyperemesis gravidarum, preeclampsia, or thyroid dysfunction may occur. The cysts gradually resolve weeks to months after the source of hCG is eliminated (13) . ...
