Montz F J, Schlaerth J B, Morrow C P
Department of Obstetrics and Gynecology, Women's Hospital, Los Angeles, California.
Obstet Gynecol. 1988 Aug;72(2):247-51.
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.
回顾了386例未经治疗的葡萄胎患者的病史，以明确伴随黄素囊肿的临床特征。这些囊肿出现在102例患者中（26.4%），3例患者出现了与囊肿相关的并发症。诊断时囊肿的平均大小为7.3厘米（3 - 20厘米），与葡萄胎后滋养细胞疾病的发生无关。双侧囊肿在发生葡萄胎后滋养细胞疾病的患者中更为常见。在患有葡萄胎后滋养细胞疾病的患者中，83%（54例中的45例）黄素囊肿消退，16.7%的患者囊肿大小随β - hCG水平下降而增大。44例患者发生了葡萄胎后滋养细胞疾病。在β - hCG水平平稳/上升的患者中，31.8%出现黄素囊肿增大，在β - hCG水平下降的患者中这一比例为4.5%。在诊断葡萄胎后滋养细胞疾病之前，31.8%的患者黄素囊肿消失。在β - hCG水平下降后，3例患者的黄素囊肿长期存在（15 - 18周）。我们得出结论，黄素囊肿常伴随葡萄胎出现，并与葡萄胎后滋养细胞疾病风险增加相关，囊肿双侧性或葡萄胎严重并发症时该风险更高。黄素囊肿很少出现严重并发症；其临床行为并不完全取决于β - hCG水平的变化，因为在β - hCG水平下降后囊肿可能长期存在。
