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Pregnancy and Skin Disease
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Tugba Kevser Uzuncakmak, Ozge Askin, Yalçın Tüzün
Overview: During pregnancy, varying degrees of hirsutism and/or hypertrichosis can be seen. These are characterized by the terminal or vellus-type hair growth on the face, the lower part of the abdomen, chest, legs, arms, back, and buttocks, being more prominent in darker-skinned women. Midline hypertrichosis may appear in the suprapubic region due to the increase in ovarian androgen. These usually regress within 6 months postpartum. Excessive hirsutism may be suggestive of lutein cysts, luteoma, and androgen-secreting tumors.
Variation of sex differentiation
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Anne-Marie Amies Oelschlager, Margarett Shnorhavorian
Excess androgen exposure resulting in virilization of the genitalia of a 46,XX patient may be a result of antenatal androgen exposure only during gestation. This may be related to the production of androgen from a maternal ovarian luteoma or tumor in pregnancy or may be related to environmental exposures, including inadvertent exposure to testosterone gels or creams. The mother should be asked about any medications used in pregnancy, including teratogens (i.e., phenytoin), as well as endocrine medications (i.e., danazol and progestins).
Reproductive System and Mammary Gland
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Justin D. Vidal, Charles E. Wood, Karyn Colman, Katharine M. Whitney, Dianne M. Creasy
Lesions arising from sex cord–stromal elements are one of the most common types of proliferative changes observed in nonclinical species (Alison et al. 1987; Dixon et al. 1999; Lewis 1987). Stromal hyperplasia, with varying degrees of luteinization, is a commonly observed age-related change and can occur secondary to elevations in gonadotropins during anestrus or menopause. Tumors arising from sex cord-stroma often have distinct features and may be classified based on cell of origin. Subtypes include granulosa cell tumors, thecal cell tumors (thecoma), luteoma, and Sertoli cell tumors. Granulosa cell tumors are the most commonly observed primary ovarian tumor in rodents and have also been observed in dogs and NHPs (Alison et al. 1987; Cline et al. 2008; Dixon et al. 1999; Kennedy et al. 1994; Lewis 1987). Granulosa cell tumors can rarely be seen in bitches as young as 14 months and are observed on occasion as spontaneous ovarian tumors in toxicology studies (Figure 20.39) (McEntee 1990a). Approximately 80% of these tumors are benign (Dow 1960; Norris et al. 1970) and unilateral. In practice it may be difficult to distinguish these different subclassifications and a diagnosis of mixed sex cord–stromal tumor can be used.
A case of excision of ovarian torsion necrosis due to luteoma in a female who conceived a twin pregnancy through in vitro fertilization misdiagnosed with acute appendicitis
Published in Gynecological Endocrinology, 2022
Lihua Zhu, Dachuan Zhang, Yanjun Yang
Luteoma of pregnancy is a very rare benign ovarian tumor characterized by luteinized cell proliferation, which usually occurs during pregnancy and is relieved after delivery [1]. Luteoma is usually found during cesarean section or postpartum ligation of the fallopian tubes. Luteoma of pregnancy may occur in unilateral or bilateral ovaries and 1/3 of cases are bilateral lesions [2]. Fewer than 300 cases of luteoma in pregnancy have been reported in the literature [3]. However, the actual incidence rate of luteoma may be higher because luteomas are not noted in most cases, in which they either produce a small amount of androgen or the androgen does not present the phenotype because of the parent protection mechanism [4]. Patients who have a luteoma in pregnancy are usually asymptomatic. The most common clinical symptoms are virilism, torsion of the luteoma and acute abdominal pain. More than 50% of female newborns have male tendency characteristics in cases of luteoma while male newborns are asymptomatic [5].
Ovarian cysts in pregnancy: a narrative review
Published in Journal of Obstetrics and Gynaecology, 2021
Sachintha Senarath, Alex Ades, Pavitra Nanayakkara
A few additional causes of adnexal masses are unique to pregnancy (Table 1). Theca-lutein cysts can occur when human chorionic gonadotrophin (hCG) concentrations are abnormally elevated such as in molar pregnancy, fetal hydrops, or multiple gestations (Di Saia et al. n.d.). Hyperreactio luteinalis (HL) is a very rare condition of cystic enlargement of the ovaries due to multiple benign theca lutein cysts, most often associated with trophoblastic disease (Skandhan and Ravi 2014). It does not usually require treatment and is most often found incidentally at the time of caesarean section. However, it can present as a mass or acute abdomen throughout pregnancy leading to a mistaken diagnosis of malignancy or result in an inadvertently unnecessary operation. Similarly, a luteoma is a rare, benign, tumour-like mass of the ovary that emerges during pregnancy and regresses spontaneously after delivery (Choi et al. 2000). Bilateral enlarged ovaries, presenting as a mass, can be part of ovarian hyperstimulation syndrome (OHSS), an iatrogenic complication of assisted reproduction techniques (ART). The incidence of moderate OHSS is estimated to be between 3−6%, while the severe form may occur in 0.1–3% of all ART cycles (Sousa et al. 2015). Surgery is warranted in severe cases where the ovaries are enlarged beyond 12 cm, but the less severe cases can be managed conservatively due to their self-limiting nature (Alalade and Maraj 2017).