Composite Mucinous and Granulosa-Cell Tumor of Ovary: Case Report of a Unique Neoplasm

Primary Ovarian Mucinous Cystic Tumor With Prominent Theca Cell Proliferation and Focal Granulosa Cell Tumor in its Stroma: Case Report, Literature Review, and Comparison With Sertoli-Leydig Cell Tumor With Heterologous Elements

“…There have been 3 case reports of intimately associated mucinous tumors and granulosa cell tumors that appear essentially similar to the current case (3)(4)(5), and several others that merit consideration in the following discussion but are likely or definitively different phenomena (6)(7)(8)(9). The cases we accept as similar were, like our case, grossly cystic with a minor granulosa cell component.…”

“…The simplest explanation would be a collision tumor, but in our case and the 3 other composite cases (3)(4)(5) the intimate admixture of the 2 components is inconsistent with a collision tumor. If these tumors are not due to collision, one component must be arising within a tumor of the other type-the question is therefore whether these are fundamentally mucinous tumors, or conversely, granulosa cell tumors with heterologous differentiation, analogous to that seen in about 20% of SLCTs (1).…”

“…Clinically, our patient presented with vaginal bleeding, suggesting the possibility of estrogen production by her ovarian tumor. One case in the literature had symptoms of estrogen deprivation following removal of the tumor (5). Hormonal symptoms were not reported in the others, who presented mainly with symptoms related to mass effect.…”

“…The mucinous epithelium is rarely associated with other sex cord stromal tumors; there are sporadic reports of benign (3)(4)(5) or malignant (6) mucinous epithelial tumors occurring in intimate association with granulosa cell tumors, as well as one report of associated stromal tumor with minor sex cord elements and mucinous cystadenoma (7). Whether this phenomenon is analogous to that seen with greater frequency in SLCTs remains uncertain.…”

Androblastoma of the Ovary: Clinical, Diagnostic and Histopathologic Features

“…The broad range of histological patterns creates difficulties in making a clear diagnosis; various other tumor types are capable of imitating Sertoli-Leydig cell tumors [33]. Mixed tumors (moderately to poorly differentiated androblastoma with mucinous elements of intestinal differentiation) have also been described [34]. Only the final detailed examination of a paraffin section can provide the necessary diagnostic certainty.…”