Juvenile Type Granulosa Cell Tumor

Abstract

Granulosa cell tumor is a type of neoplasm, which represents 2-5% of all ovarian cancers. About 5% of these tumors are juvenile- type and usually occur to girls before puberty and to women younger than thirty years of age. There are signs premature puberty or premature emergence of secondary sexual characteristics with irregular vaginal bleeding that occur to these kind of patients. To the rare cases, like this, the occurrence of granulosa cell tumors can cause the appearance of hyperandrogenism with high levels of plasma testosterone, leading to virilization which happened to this female patient. We will present the female patient who was 35 years old and which was originally hospitalized to the Clinic for Haematology Clinical Center Kragujevac, because of extreme fatigue accompanied by dizziness. During diagnostics the patient underwent to the complete gynecological examination. After gynecological examinations and necessary diagnostic procedures, it was decided continuing the treatment at the Clinic of Gynecology and Obstetrics Clinical Center Kragujevac, where she underwent a total abdominal hysterectomy with bilateral salpingo- oophorectomy for suspected uterine neoplasm. Histopathological analysis of the obtained material confirmed the presence of follicular cysts of both ovaries and juvenile type granulosa cell tumor on the right ovary; the uterus was enlarged with multiple fibroid tumors. Granulosa cell tumor should be suspected in the cases of girls and young females if there is present an ovarian cyst paired with signs of preterm puberty or hyperestrogenism. In this case, the presence of granulosa cell tumor was masked by signs of hyperandrogenism, which is not so typical, as well as the presence of uterine fibroids who have actually been the main cause for surgical treatment.

Juvenile granulosa cell tumor: 20 years’ experience of a Tertiary Center

“…Ovarian cancers are the fourth most seen cancer in women after breast, lung and colorectal cancer [10]. Primary ovarian malignancies are originated in three subgroups according to cells they originate from: tumors of ovarian surface epithelium, germ cells, and sex cord cells [11].…”

“…JGCT is generally seen in the first 30 years of life at median age of seven years [10]. The literature review revealed that more than 50% of patients are under 20 years old [12].…”

“…The diagnosis of granulosa cell tumors is made by the clinical presentations of the patients and diagnostic imaging procedures must be used [10]. JGCT's are large in size.…”