Ovary - nontumor
Nonneoplastic cysts / other
Pregnancy luteoma

Author: Shahid Islam, M.D. (see Authors page)

Revised: 22 September 2017, last major update June 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Pregnancy luteoma ovary

Cite this page: Islam, S. Pregnancy luteoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarypregnancyluteoma.html. Accessed October 23rd, 2017.
Definition / general
  • Single or multiple nodules of luteinized cells with abundant eosinophilic cytoplasm, detected during pregnancy
  • Rare (100 cases described), probably hyperplasia due to hCG, not neoplasia
  • 80% in multiparous women, 80% in blacks
  • Usually an incidental finding at cesarean section or postpartum tubal ligation
  • 25% are associated with virilization in latter half of pregnancy, 2/3 of female infants of virilized mothers are virilized (note: usually placenta aromatizes androgens to estrogens); testosterone levels are 70x normal, elevated even in nonvirilized patients
Case reports
  • 33 year old woman with luteoma presenting as ovarian torsion with rupture and intra-abdominal bleeding (Singapore Med J 2008;49:e78)
  • 34 year old woman with prenatal diagnosis of female pseudohermaphroditism associated with bilateral luteoma of pregnancy (Hum Reprod 2002;17:821)
Treatment
  • None - tumors are benign and regress weeks after delivery (infarct like necrosis leads to scar)
Gross description
  • Soft, fleshy, circumscribed, yellow / orange nodules, hemorrhagic, may be very large
  • 1/3 bilateral, 1/2 multiple, may see separate corpus luteum
Gross images

Images hosted on other servers:

Bilaterally enlarged ovaries

Multicentric and bilateral tumor

Microscopic (histologic) description
  • Sharply circumscribed, rounded masses of polygonal cells with abundant pink cytoplasm containing little lipid (theca - lutein cells), round nuclei, variably prominent nucleoli, mild nuclear atypia
  • 2 - 3 MF/10 HPF, scant stroma; may have colloid filled spaces
Microscopic (histologic) images

Images hosted on PathOut server:

Several follicle-like spaces are present

Cells have abundant
eosinophilic cytoplasm
and regular, round nuclei
with prominent nucleoli

Two mitotic figures are visible



Images hosted on other servers:

Various images

Electron microscopy description
  • Smooth ER, dispersed Golgi, tubular cristae in mitochondria (associated with steroid hormone producing cells)
Differential diagnosis