From the Guidelines
The corpus luteal cyst functions as a temporary ovarian structure that develops from the corpus luteum, which forms after ovulation, with its primary purpose being to produce progesterone and some estrogen to maintain the uterine lining during the early stages of pregnancy or until menstruation begins if pregnancy doesn't occur. The corpus luteal cyst is a normal physiological structure that typically measures less than 3 cm in diameter, as indicated by the O-RADS US risk stratification and management system 1. This system categorizes such cysts as having a low likelihood of malignancy, especially in premenopausal women.
Key Characteristics and Functions
- The corpus luteal cyst is a temporary structure that resolves on its own within a few menstrual cycles.
- It plays a crucial role in producing hormones essential for maintaining the uterine lining.
- If pregnancy occurs, the corpus luteal cyst continues to produce hormones until the placenta takes over, usually around 8-10 weeks of pregnancy.
- Most corpus luteal cysts are asymptomatic and require no treatment, although they may occasionally cause pelvic pain, delayed menstruation, or mild bloating.
Differentiation from Pathological Ovarian Cysts
- Corpus luteal cysts differ from pathological ovarian cysts in that they are a normal part of the menstrual cycle and reproductive function rather than abnormal growths.
- The risk of malignancy in simple cysts, including corpus luteal cysts, is very low, as supported by recent studies and guidelines 1.
- The American College of Radiology and other professional bodies have guidelines for the management of adnexal masses, including the recommendation for follow-up of simple cysts based on size and menopausal status.
Management and Follow-Up
- For premenopausal women, simple cysts less than 5 cm do not typically require follow-up, according to recent consensus updates 1.
- Larger cysts or those that persist may require follow-up or further evaluation to confirm their benign nature or to assess for any changes.
- The management approach prioritizes minimizing unnecessary interventions while ensuring the early detection of any potential malignancies, thus optimizing outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Function of the Corpus Luteal Cyst
The corpus luteal cyst plays a crucial role in supporting early pregnancy, as evidenced by the case study in 2. The removal of the corpus luteum cyst during laparoscopic oophorectomy did not hinder the continuation of the pregnancy, likely due to the initiation of hormonal therapy.
Characteristics and Complications
- The corpus luteum cyst is characterized by intense endocrine activity, producing a surplus of steroids, particularly progesterone 3.
- These cysts can cause bleeding, often of slight entity but also severe, representing a frequent and dangerous complication, especially in women subjected to anticoagulant treatment 3.
- Ruptured corpus luteum cysts are a common diagnosis in cases of ruptured ovarian cysts, often presenting with abdominal pain 4.
Diagnosis and Management
- Pelvic or intravaginal ultrasound is the first-line imaging modality used for diagnosis and evaluation of suspected ovarian/adnexal torsion, with ovarian enlargement being the most sensitive marker and ovarian edema being the most specific marker 5.
- Ovarian torsion, often associated with corpus luteal cysts, requires urgent surgical intervention to prevent permanent loss of the affected ovary 2, 6.
- Conservative management may be feasible in some cases, but surgery is often necessary in cases of haemodynamic compromise or association with torsion 4.