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Hemorrhagic Corpus Luteum

Faye C Laing, MD

March 28, 1994

Presentation

A 38-year-old woman presented with palpable left adnexal mass and minor discomfort.

Imaging Findings

Transverse transabdominal Ultrasound
Transvaginal Ultrasound

Transverse transabdominal scan (3.5 MHz) reveals a grossly normal appearing uterus and right ovary. A well defined, hypoechoic 3-4 cm left adnexal mass is consistent with a cyst (arrow). Sound transmission is good. The several low level echoes (arrow) in the posterior portion of the mass could be real or artifactual.

The transvaginal scan (5.0 MHz) shows the left ovarian cyst with much greater clarity. The posterior low level echogenicity, seen on the abdominal scan is not confirmed on the transvaginal image. There are, however, several fine, strand-like areas of echogenicity (arrow) in the superficial aspect of the cyst. Small follicles are also visible in the periphery of the ovary.

Differential Diagnosis

The appearance of this complex cyst is most consistent with an evolving hemorrhagic corpus luteum. Other less likely etiologies include neoplasm and infection. Doppler examination might not be useful in this case since all three conditions can have prominent diastolic blood flow.

Diagnosis

Hemorrhagic corpus luteum

Discussion

Since this patient's history revealed only minor discomfort, a repeat sonographic examination should be considered at the onset of menstruation, following one or two menstrual cycles. During this time frame a hemorrhagic corpus luteum should resolve, and a normal appearing ovary, with relatively high resistance blood flow, should be observed.

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