The cyst is typically unilocular usually up to 5 cm in diameter with a convoluted yellow wall. The contents vary from serous or serosanguinous fluid to clotted blood. The cyst wall is composed of an inner connective tissue layer, a middle layer of large luteinized granulosa cells and an outer layer of small, luteinized theca interna cells. Clinical behavior Usually self-limited with spontaneous regression. These are multiple bilateral luteinized follicular cysts that occur most frequently with disorders causing increase serum human chorionic gonadotrophin levels such as pregnancy especially multiple gestation, hydatidiform mole, choriocarcinoma, fetal hydrops, exogenous hCG treatment, clomiphene treatment or polycystic ovary.
Abdominal symptoms are usually minimal.
The condition may be detected as a pelvic mass during any trimester, at Cesarean section, or rarely immediately postpartum or after puerperium. Abdominal pain may result when there is hemorrhage into cyst, torsion with infarction or rupture with intra-abdominal hemorrhage occurs. It is bilateral, usually causing moderately to massively enlargement of the ovaries, which contain multiple, thin-walled cysts filled with clear or hemorrhagic fluid. The cysts are rarely large. The cysts show marked luteinization of the theca interna cells and, in some cases, the granulosa cells.