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This is a case report of recurrent bilateral ovarian cysts in pregnancy. From the clinical picture these are likely to be theca lutein cysts. A lookout for complications involving these cysts is important. Patients can be managed conservatively in the absence of complications. Likely mechanisms for the causation of this phenomenon are discussed.

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A 23-year-old female with polycystic ovary syndrome (PCOS) and a growth-hormone (GH)-producing pituitary adenoma is described. A reduction in the elevated GH levels to normal levels following the administration of dopaminergic agents decreased plasma insulin-like growth factor (IGF)-1 and ovarian dysfunction. Menstrual cycles were therefore restored and the number of ovarian cysts reduced, suggesting that insulin and/or IGF-1, stimulators of theca cell proliferation, may be pathogenetic factors in PCOS.

Adenomatoid mesothelioma is a rare benign tumor, most commonly located in the uterine corpus and fallopian tubes in the women during the reproductive years. It usually occurs occasionally and there are no specific symptoms. A case is presented of an adenomatoid tumor of the fallopian tube, associated with many other pathological findings of the genital tract. It is important to recognize the pseudoglandular pattern of this rare kind of benign tumor to avoid a mistaken diagnosis of adenocarcinoma or metastasis.

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Ovarian hyperthecosis has been described exclusively as bilateral. It occurs predominantly in perimenopausal women but may be seen at any age after puberty. In a young woman, stromal hyperthecosis is characterized by virilism, menstrual disorders and infertility. Ovarian suppression therapy, induction of ovulation and wedge resection of the ovaries have been ineffective, and only bilateral oophorectomy has caused regression of virilism in these patients. Conservative surgery in appropriate cases may save many young women desiring pregnancy from having bilateral oophorectomy. This case report describes a unique situation in which a young woman with ovarian hyperthecosis achieved three pregnancies after unilateral oophorectomy, indicating the possibility of unilateral ovarian hyperthecosis in our patient.

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