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The recognition that pregnancy in chronic renal failure may result in theca lutein cysts, presumably due to excessive serum beta human chorionic gonadotropins (hCGs) secondary to impaired renal excretion, expands the differential diagnosis for this MRI appearance, in addition to the usual considerations of gestational trophoblastic disease, multiple gestation, and ovarian hyperstimulation. J. Magn. Reson. 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