Atypical presentation and localization of granulosa cell tumor—A case report and review of the literature (original) (raw)
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Granulosa Cell Tumors of the Ovary: A Retrospective Tertiary Center Experience
Journal of clinical obstetrics & gynecology, 2021
Granulosa cell tumor (GCT) is a rare ovarian malignancy originating from sex cord-stromal cells. Sex cord stromal tumors account for 5-8% of all ovarian malignancies. 1 GCTs, which constitute approximately 70% of sex cord stromal ovarian tumors, are seen in 0.4-1.7 per 100,000 women. They are divided into 2 subgroups as juvenile (5%) and adult (95%) tumors based on their clinical presentation and histologic characteristics. The only clinically proven prognostic factor regarding recurrence is stage. However, patient age, tumor size, presence of intraperitoneal disease and the scope of the operation also play a role in prognosis. 2 Histological prognostic factors include nuclear atypia and mitosis. 3 Average recurrence is 5 years after surgery for the primary tumor. However, cases recurring even 20-30 years after the initial diagnosis have been reported in the literature. 4 Only 2% of GCT cases are bilateral, and most cases are diagnosed at Stage 1. Synchronous GCT has also been reported very rarely. They are usually lowgrade tumors with good prognosis. The most common presentation includes abdominal pain and distention. 5 Also they can secrete estrogen. Endometrial thickness should be evaluated with transvaginal ultrasound
Case series of rare ovarian malignancy: granulosa cell tumor
International Journal of Research in Medical Sciences, 2017
Granulosa cell tumors are rare ovarian sex cord stromal tumors characterized by indolent course and favorable prognosis. The treatment of granulosa cell tumor is individualized based on many factors like age, desire for future fertility and stage of the disease. Here, we report three cases out of which two were acute presentation and one was diagnosed incidentally when she got evaluated for menstrual irregularity. Fertility sparing surgery with proper staging is offered to young patients presenting in early stage. In patients who have completed family, comprehensive surgical staging including hysterectomy with bilateral salpingo oophorectomy is the standard treatment. Lymph node metastasis in granulosa cell tumor is very rare, hence pelvic and para aortic lymphadenectomy can be safely avoided if preoperative findings and frozen section favour granulosa cell tumor.
Pelvic ultrasound scanning in asymptomatic adult-type granulosa cell tumor: A case report and review
2021
Background: Ovarian cancer is common amongst women worldwide. In Indonesia, it is the fourth most common female cancer with a 5-year survival rate of 45%, but can reach up to 92% if treated early. Granulosa cell tumors (GCT) arise from the sex-cord and are considered malignant. This study presents a rare case of asymptomatic adult-type granulosa cell tumor in an elderly lady diagnosed during routine pelvic ultrasound scanning. Case Illustration: A 65-year-old lady, P2A0, was referred due to left ovarian mass three years before admission. A left adnexal mass was palpated with no sign of internal genital adhesion. Transvaginal ultrasound showed atrophy of uterus and thin endometrial layer. One solid adnexal mass with a cystic part was found on the left adnexal with papillary projection and low resistance index. Histopathological examination revealed adult type-granulosa cell tumor and classical Call-Exner body with grooved nuclei (coffee bean nuclei). Diagnosis of GCT was made by hist...
Kathmandu University Medical Journal, 2015
Approximately one-fourth of the ovarian neoplasms and cysts are diagnosed incidentally during caesarean section. The possibility of borderline tumor or cancer should be considered although existence of ovarian malignancy in pregnancy is rare. We report a case of a rare solid malignant tumor of the ovary incidentally found during caesarean section. Intraoperatively, it was thought to be a variant of the common ovarian teratoma. Ovariectomy was done but histopathology revealed it to be granulosa cell tumor. The diagnosis changed the prognosis and future treatment plan drastically. Equipped with this knowledge physicians can be made aware of the existence of this little-known ovarian neoplasm along with its rare association with pregnancy. Also one can better manage, counsel and follow-up the patients after delivery, given the knowledge of the tumours' inevitable malignant potential and its high incidence of recurrence.
A Cystic Granulosa Cell Tumor of Ovary: An Incidental Finding in a 50 years Old Lady
Annals of Pathology and Laboratory Medicine
Granulosa cell tumours (GCTs) are rare ovarian sex cord stromal tumours. GCTs usually are oestrogen producing neoplasms and hence consequently, symptoms related to hyperestrogenism are common at the time of diagnosis. Here we document a case of cystic GCT that was incidentally discovered on histopathological examination. An abdominal hysterectomy was done for abnormal uterine bleeding in a 50 years old lady, clinically was thought to be due to uterine fibroid. A unilateral oophorectomy was also done due to a small cyst in the left ovary, which on histopathological examination revealed cystic granulosa cell tumour in the ovary. Equipped with this knowledge, a better clinical correlation with the presenting symptoms could be made in future by clinicians and pathologists. The final diagnosis may change the prognosis and also the future treatment plan.
Adult granulosa cell tumor associated with endometrial carcinoma: a case report
Journal of Medical Case …
Introduction: If strict criteria for the diagnosis of carcinoma are used and all patients with granulosa cell tumors are considered, the best estimate of the incidence of associated endometrial carcinomas is under 5%. In patients with granulosa cell tumors, estrogen-dependent endometrial cancers are rarely found, and most of these endometrial cancers are well-differentiated endometrioid adenocarcinomas that carry a good prognosis when detected early. Case presentation: We report the case of a 65-year-old post-menopausal Nigerian woman of the Igbo tribe with an adult granulosa cell tumor that was initially treated as endometrial carcinoma. She underwent a total abdominal hysterectomy and a bilateral salpingo-oophorectomy after histopathologic confirmation of a well-differentiated granulosa cell tumor of the ovary and a nuclear grade 1 adenocarcinoma of the endometrium (International Federation of Obstetricians and Gynecologists stage 1B). She had a good post-operative recovery and was discharged 10 days after treatment. Conclusion: The association between adult granulosa cell tumors of the ovary and endometrial carcinomas is rare. A high index of suspicion as well as good imaging and histopathologic analyses are important in making this diagnosis.
Adult granulosa cell tumor of ovary in a young female: A rare case report
Indian Journal of Pathology and Oncology
Granulosa cell tumours (GCT) belong to the group of sex cord and stromal tumours of ovary. Adult granulosa cell tumours account for approximately 1% of all ovarian tumours and 95% of all granulosa cell tumours. They are found more often in postmenopausal than premenopausal women, with a peak incidence between 50 and 55 years of age. We present the case of a 35-year female who came with white discharge, irregular menses and excessive bleeding during menses since 5 to 6 months. The complete blood picture with peripheral smear examination, kidney and liver function tests were all within normal limits. CT abdomen was advised which revealed a large solid cystic lesion of left ovarian origin. Surgical intervention was done and histopathology revealed adult granulosa cell tumor of ovary.
Adult Granulosa Cell Tumor in Pregnancy: A New Case and a Review of the Literature
Healthcare
Granulosa cell tumors are rare ovarian tumors that can arise during pregnancy. We present a new case of recurrent adult granulosa cell tumor (AGCT) in pregnancy and a systematic review of the literature. The new case described is a 41-year-old woman G5P1122 with a prior history of AGCT that was referred to our center at 29 weeks because of a symptomatic abdominal mass, compatible with a possible recurrence of AGCT. At 36 + 3 weeks, she underwent a cesarean delivery for preterm labor and a total hysterectomy with a radical surgical staging. A healthy female infant was delivered. The patient received a platinum-based chemotherapy, with a 26-month follow-up negative for recurrence. Analyzing our case with the four identified by the literature review, three were recurrent and two were primary AGCT. Only one required surgery for AGCT at 15 weeks, while another underwent chemotherapy in pregnancy. In the other three cases, surgery for AGCT was done at the time of cesarean delivery. There ...