Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review

Abstract Introduction This study aimed to investigate the imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma. Material and methods We retrospectively analyzed patients with pregnancy luteoma admitted to the First Affiliated Hospital of Sun Yat‐sen University betwee...

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Main Authors: Jian‐Hong Shang, Cai‐Xin Huang, Qiao Zheng, Jie‐Ling Feng, Ke He, Hong‐Ning Xie
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14672
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author Jian‐Hong Shang
Cai‐Xin Huang
Qiao Zheng
Jie‐Ling Feng
Ke He
Hong‐Ning Xie
author_facet Jian‐Hong Shang
Cai‐Xin Huang
Qiao Zheng
Jie‐Ling Feng
Ke He
Hong‐Ning Xie
author_sort Jian‐Hong Shang
collection DOAJ
description Abstract Introduction This study aimed to investigate the imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma. Material and methods We retrospectively analyzed patients with pregnancy luteoma admitted to the First Affiliated Hospital of Sun Yat‐sen University between January 2003 and December 2022. We recorded their imaging features, clinical characteristics and neonatal outcomes. Additionally, we reviewed relevant studies in the field. Results In total, 127 cases were identified, including eight from our hospital and 119 from the literature. Most patients (93/127, 73.23%) were of reproductive age, 20–40 years old, and 66% were parous. Maternal hirsutism or virilization (such as deepening voice, acne, facial hair growth and clitoromegaly) was observed in 29.92% (38/127), whereas 59.06% of patients (75/127) were asymptomatic. Abdominal pain was reported in 13 patients due to compression, torsion or combined ectopic pregnancy. The pregnancy luteomas, primarily discovered during the third trimester (79/106, 74.53%), varied in size ranging from 10 mm to 20 cm in diameter. Seventy‐five cases were incidentally detected during cesarean section or postpartum tubal ligation, and 39 were identified through imaging or physical examination during pregnancy. Approximately 26.61% of patients had bilateral lesions. The majority of pregnancy luteomas were solid and well‐defined (94/107, 87.85%), with 43.06% (31/72) displaying multiple solid and well‐circumscribed nodules. Elevated serum androgen levels (reaching values between 1.24 and 1529 times greater than normal values for term gestation) were observed in patients with hirsutism or virilization, with a larger lesion diameter (P < 0.001) and a higher prevalence of bilateral lesions (P < 0.001). Among the female infants born to masculinized mothers, 68.18% (15/22) were virilized. Information of imaging features was complete in 22 cases. Ultrasonography revealed well‐demarcated hypoechoic solid masses with rich blood supply in 12 of 19 cases (63.16%). Nine patients underwent magnetic resonance imaging (MRI) or computed tomography (CT), and six exhibited solid masses, including three with multi‐nodular solid masses. Conclusions Pregnancy luteomas mainly manifest as well‐defined, hypoechoic and hypervascular solid masses. MRI and CT are superior to ultrasonography in displaying the imaging features of multiple nodules. Maternal masculinization and solid masses with multiple nodules on imaging may help diagnose this rare disease.
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spelling doaj-art-e13ac7e2636d46209181fbcf441428762025-08-20T02:09:29ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-04-01103474075010.1111/aogs.14672Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature reviewJian‐Hong Shang0Cai‐Xin Huang1Qiao Zheng2Jie‐Ling Feng3Ke He4Hong‐Ning Xie5Department of Ultrasonic Medicine First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Ultrasonic Medicine First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Ultrasonic Medicine First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Ultrasonic Medicine First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Obstetrics and Gynecology First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Ultrasonic Medicine First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaAbstract Introduction This study aimed to investigate the imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma. Material and methods We retrospectively analyzed patients with pregnancy luteoma admitted to the First Affiliated Hospital of Sun Yat‐sen University between January 2003 and December 2022. We recorded their imaging features, clinical characteristics and neonatal outcomes. Additionally, we reviewed relevant studies in the field. Results In total, 127 cases were identified, including eight from our hospital and 119 from the literature. Most patients (93/127, 73.23%) were of reproductive age, 20–40 years old, and 66% were parous. Maternal hirsutism or virilization (such as deepening voice, acne, facial hair growth and clitoromegaly) was observed in 29.92% (38/127), whereas 59.06% of patients (75/127) were asymptomatic. Abdominal pain was reported in 13 patients due to compression, torsion or combined ectopic pregnancy. The pregnancy luteomas, primarily discovered during the third trimester (79/106, 74.53%), varied in size ranging from 10 mm to 20 cm in diameter. Seventy‐five cases were incidentally detected during cesarean section or postpartum tubal ligation, and 39 were identified through imaging or physical examination during pregnancy. Approximately 26.61% of patients had bilateral lesions. The majority of pregnancy luteomas were solid and well‐defined (94/107, 87.85%), with 43.06% (31/72) displaying multiple solid and well‐circumscribed nodules. Elevated serum androgen levels (reaching values between 1.24 and 1529 times greater than normal values for term gestation) were observed in patients with hirsutism or virilization, with a larger lesion diameter (P < 0.001) and a higher prevalence of bilateral lesions (P < 0.001). Among the female infants born to masculinized mothers, 68.18% (15/22) were virilized. Information of imaging features was complete in 22 cases. Ultrasonography revealed well‐demarcated hypoechoic solid masses with rich blood supply in 12 of 19 cases (63.16%). Nine patients underwent magnetic resonance imaging (MRI) or computed tomography (CT), and six exhibited solid masses, including three with multi‐nodular solid masses. Conclusions Pregnancy luteomas mainly manifest as well‐defined, hypoechoic and hypervascular solid masses. MRI and CT are superior to ultrasonography in displaying the imaging features of multiple nodules. Maternal masculinization and solid masses with multiple nodules on imaging may help diagnose this rare disease.https://doi.org/10.1111/aogs.14672imaging findingsmasculinizationmulti‐nodular signpregnancy luteomatumor‐like ovarian lesion
spellingShingle Jian‐Hong Shang
Cai‐Xin Huang
Qiao Zheng
Jie‐Ling Feng
Ke He
Hong‐Ning Xie
Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review
Acta Obstetricia et Gynecologica Scandinavica
imaging findings
masculinization
multi‐nodular sign
pregnancy luteoma
tumor‐like ovarian lesion
title Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review
title_full Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review
title_fullStr Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review
title_full_unstemmed Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review
title_short Imaging features, clinical characteristics and neonatal outcomes of pregnancy luteoma: A case series and literature review
title_sort imaging features clinical characteristics and neonatal outcomes of pregnancy luteoma a case series and literature review
topic imaging findings
masculinization
multi‐nodular sign
pregnancy luteoma
tumor‐like ovarian lesion
url https://doi.org/10.1111/aogs.14672
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AT qiaozheng imagingfeaturesclinicalcharacteristicsandneonataloutcomesofpregnancyluteomaacaseseriesandliteraturereview
AT jielingfeng imagingfeaturesclinicalcharacteristicsandneonataloutcomesofpregnancyluteomaacaseseriesandliteraturereview
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