1
|
Arun Kumar D, Aiyappan SK. Imaging findings of granulosa cell tumour of right ovary with rupture and torsion presenting as acute abdomen. BMJ Case Rep 2024; 17:e259517. [PMID: 38490713 PMCID: PMC10946348 DOI: 10.1136/bcr-2023-259517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Deepthi Arun Kumar
- Radiodiagnosis, SRM Medical college hospital and research centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Senthil Kumar Aiyappan
- Radiodiagnosis, SRM Medical college hospital and research centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| |
Collapse
|
2
|
Kotowski K, Małyszczak P, Towarek M, Jagasyk A, Murawski M, Sozański R. An unusual coincidence of giant cervical leiomyoma and incidental ovarian granulosa cell tumor: A case report. Medicine (Baltimore) 2023; 102:e34387. [PMID: 37505129 PMCID: PMC10378814 DOI: 10.1097/md.0000000000034387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023] Open
Abstract
RATIONALE Leiomyomas are the most common benign tumors of smooth muscle origin in women. They are most frequently found in the submucosal tissue of the uterine corpus; however, they also occur in other areas of the uterus, including the cervix. Their size usually varies between 0.5 to 1.0 cm; however, they can reach great dimensions. A strong correlation between the onset and growth of leiomyomas and estrogen levels was observed. Granulosa cell tumor (GCT) is an infrequent sex cord-stromal ovarian neoplasm. Despite their malignancy, GCTs have a good long-term prognosis. In this study, we present a unique case of coincidence of 2 tumors: leiomyoma of rare location (cervix uteri) and extraordinary size (9, 04 cm diameter) with an adult granulosa cell tumor. PATIENT CONCERNS A 67-year-old Caucasian woman was transported from an emergency ward to a gynecological surgery department due to a massive vaginal hemorrhage. DIAGNOSES Preliminary examination showed a presence of an enormous uteri cervix tumor. INTERVENTIONS Initially, the patient underwent physical and ultrasound examinations. To prevent further bleeding, an urgent surgery (hysterectomy) with bilateral salpingo-oophorectomy was performed. OUTCOME Postoperative histopathological examination revealed a cervical leiomyoma and the incidental occurrence of an adult GCT in the right ovary. LESSONS This case shares an interesting coincidence between a rare variant of leiomyoma and GCT. The study suggests that the potential reason for this can be estrogen secreted by the GCT, which causes the enormous size of the patient's cervical leiomyoma and the severe vaginal bleeding. Therefore, we advise it is important in abnormal cases to search for other hidden explanations, as in cases of GCT.
Collapse
Affiliation(s)
| | | | | | | | - Marek Murawski
- Medical University Hospital, Wroclaw, Poland
- First Department of Obstetrics and Gynecology, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Sozański
- Medical University Hospital, Wroclaw, Poland
- First Department of Obstetrics and Gynecology, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
3
|
Gu C, Zeng X, Shi Q, Xiao Q, He Y. Androgen-secreting adult granulosa cell tumor in a woman with polycystic ovary syndrome: a case report. Gynecol Endocrinol 2022; 38:1014-1016. [PMID: 36367302 DOI: 10.1080/09513590.2022.2143491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To present the clinicopathologic findings of the second case of androgen-secreting adult granulosa cell tumor (AGCT) in a woman with polycystic ovary syndrome (PCOS) and discuss in the light of the literature. Methods: Description of a case and discussion of the literature. Results: A patient with oligomenorrhea, amenorrhea and hirsutism who was diagnosed as PCOS and treated by oral contraceptive for three years, then left ovarian solid and liquid mass was found and pathologically confirmed to be androgen-secreting AGCT after left oophorectomy. She got regular menstrual cycle and gave birth naturally, but clinical features of PCOS reappeared after breastfeeding. Conclusion: Androgen-secreting AGCT and PCOS have similar clinical features of hyperandrogenism, it is difficult to diagnose androgen-secreting AGCT when both diseases occur in the same patient. If the size of cystic mass in androgen-secreting AGCT is too small to differentiate from PCOM on imaging, pathological examination after surgery may be the only way to find the disease.
Collapse
Affiliation(s)
- Chongjuan Gu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaoqin Zeng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Quan Shi
- Pathology department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qing Xiao
- Department of Obstetrics and Gynecology, The Eight Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Yaojuan He
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
4
|
Ribeiro Dias-Junior A, Vieira da Motta E, Ferreira-Filho ES, Evangelista Oliveira-Junior ME, Soares-Junior JM, Baracat EC. Hyperestrogenemia resulting from a granulosa cell tumor and causing pulmonary thromboembolism: a case report. Gynecol Endocrinol 2022; 38:531-533. [PMID: 35254192 DOI: 10.1080/09513590.2022.2047921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Estrogen modulates platelet activation and aggregation, and it increases the levels of the von Willebrand factor, factors II, VII, VIII, and X, and of fibrinogen, all of which increase the risk for thromboembolism. We report the case of a 59-year-old woman, postmenopausal for 4 years, not using hormone replacement therapy, who was admitted into the emergency room with shortness of breath and increased abdominal volume. After physical examination and imaging and biochemical tests, she was diagnosed with pulmonary thromboembolism and a large left adnexal tumor. The patient was promptly received full anticoagulation therapy for the pulmonary thromboembolism. High levels of estradiol (810.4 pg/mL), anti-Mullerian hormone (16.39 ng/mL), inhibin (11250 pg/mL), and suppressed FSH (<0.16 IU/L) led to a suspicion of granulosa-cell tumor. After clinical stabilization, she underwent to an exploratory laparotomy with total hysterectomy and bilateral adnexectomy to treat the pelvic tumor. Pathologic report confirmed a granulosa-cell tumor.
Collapse
Affiliation(s)
- Altamiro Ribeiro Dias-Junior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Vieira da Motta
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Edson Santos Ferreira-Filho
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - José Maria Soares-Junior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
5
|
Burgetova A, Matejovsky Z, Zikan M, Slama J, Dundr P, Skapa P, Benkova K, Cibula D, Fischerova D. The association of enchondromatosis with malignant transformed chondrosarcoma and ovarian juvenile granulosa cell tumor (Ollier disease). Taiwan J Obstet Gynecol 2017; 56:253-257. [PMID: 28420520 DOI: 10.1016/j.tjog.2017.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Ovarian juvenile granulosa cell tumor has an interesting association with multiple enchondromatosis (Ollier disease and Maffucci syndrome) and should be considered a leading diagnosis when an ovarian mass is found in young patients with these conditions. Besides the association with nonskeletal malignancies, there is a high risk of malignant transformation of enchondroma in chondrosarcoma as was also the case in this instance. CASE REPORT The report uses multiple images to document the representative and characteristic markers of multiple enchondromas in a 22-year-old patient with Ollier disease complicated by malignant transformation of chondrosarcoma and in whom the disease is associated with ovarian juvenile granulosa cell tumor of the right ovary. CONCLUSION It is important to recognize that when the female patient presents with enchondromatosis and a large unilateral multilocular-solid ovarian mass, the specific diagnosis of granulosa cell tumor can be made with high accuracy.
Collapse
Affiliation(s)
- Andrea Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Zdenek Matejovsky
- Orthopedic Clinic, Bulovka Hospital, First Faculty of Medicine, Charles University, Czech Republic
| | - Michal Zikan
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Jiri Slama
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Pavel Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Petr Skapa
- Department of Pathology, Second Faculty of Medicine, Charles University, Czech Republic
| | - Kamila Benkova
- Department of Pathology, Bulovka Hospital, First Faculty of Medicine, Charles University, Czech Republic
| | - David Cibula
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Daniela Fischerova
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
| |
Collapse
|
6
|
Christiansen JJ, Lauszus F. [Virilization caused by a very small androgen-producing ovarian tumor]. Ugeskr Laeger 2017; 179:V69015. [PMID: 28689544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
|
7
|
Takeda A, Watanabe K, Hayashi S, Imoto S, Nakamura H. Gynandroblastoma with a Juvenile Granulosa Cell Component in an Adolescent: Case Report and Literature Review. J Pediatr Adolesc Gynecol 2017; 30:251-255. [PMID: 27751908 DOI: 10.1016/j.jpag.2016.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Gynandroblastoma is an extremely rare ovarian sex cord tumor with malignant potential. CASE An 18-year-old adolescent experienced intermittent vaginal bleeding. A year later, a right adnexal mass with a heterogeneous imaging appearance was identified. Laparoendoscopic single-site ovarian tumorectomy was performed. A histopathological examination showed gynandroblastoma composed of juvenile granulosa and Sertoli-Leydig cells. Because the tumor was upstaged to stage Ic because of cyst rupture during surgery, three cycles of adjuvant chemotherapy with carboplatin and paclitaxel were added. Three years after surgery, no signs of recurrence have been noted. SUMMARY AND CONCLUSION The present findings can help clinicians make an accurate preoperative imaging diagnosis of gynandroblastoma with a juvenile granulosa cell component and plan an adequate treatment strategy for this rare, potentially malignant neoplasm.
Collapse
Affiliation(s)
- Akihiro Takeda
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan.
| | - Kazuko Watanabe
- Department of Diagnostic Pathology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Shotaro Hayashi
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Sanae Imoto
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Hiromi Nakamura
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| |
Collapse
|
8
|
Ubetagoyena Arrieta M, Martinez Sainz de Jubera J, García de Andoin Barandiaran N, Úriz Monaut JJ, López Cuesta S, Domínguez Castells A. Hypercalcemia and hypophosphatemia in a 11 years old girl with ovarian tumor. Nefrologia 2016; 37:100-101. [PMID: 27837927 DOI: 10.1016/j.nefro.2016.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/27/2016] [Accepted: 09/05/2016] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | | | - José Javier Úriz Monaut
- Servicio de Oncología Pediátrica, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Sheila López Cuesta
- Sección de Nefrología Pediátrica, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Ana Domínguez Castells
- Servicio de Oncología Pediátrica, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| |
Collapse
|
9
|
Trösch L, Müller K, Brosinski K, Braun U. [Haemoabdomen and haemothorax in a cow with metastatic granulosa cell tumor]. SCHWEIZ ARCH TIERH 2016; 157:339-43. [PMID: 26753349 DOI: 10.17236/sat00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This case report describes the clinical, ultrasonographic, pathological and histological findings in a two-year-old Swiss Braunvieh cow with granulosa cell tumor and metastases in the abdomen and thorax. The cow was ill and had tachycardia, coughing, increased breath sounds, positive reticular foreign body tests and a tense abdominal wall. Ultrasonography revealed a massive accumulation of hypoechoic fluid in the thorax and abdomen, and abdomino- and thoracocentesis yielded red fluid indicative of abdominal and thoracic haemorrhage. Because of a poor prognosis, the cow was euthanized and examined postmortem. Multiple nodular lesions were seen in the omentum, liver, spleen and lungs. The left ovary was grossly enlarged and nodular in appearance. Histological examination of the lesions revealed granulosa cell tumour of the left ovary and metastases in the omentum, liver, spleen and lungs.
Collapse
|
10
|
Zvonařová Skalická J, Pilka R. [Peripheral precocious puberty]. Ceska Gynekol 2016; 81:377-383. [PMID: 27897024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To summarize literature data on peripheral precocious puberty. DESIGN A literature review. SETTING Středomoravská nemocniční a.s., hospital Šternberk, Department of Obstetrics and Gynaecology, University Hospital, Medical Faculty, Palacky University, Olomouc. METHODS AND RESULTS We searched in PubMed using the key words stated below according to date and published since 1980.Peripheral precocious puberty occurs in girls with the frequency 1:400-1000. It develops mainly because of peripheral estrogen secretion, the main cause of which are autonomous ovarian cysts. Other causes include McCune Albright syndrome, juvenile granulosa cell tumor and primary hypothyroidism. Typically, peripheral precocious puberty presents with early breast enlargement followed by development of other secondary sex characteristics. Initial treatment is usually conservative with the exception of juvenile granulosa cell tumor where surgery is warranted. Peripheral precocious puberty anti-estrogen therapy seems promising but neither data on its influence on fertility nor data comparing it to surgical treatment are available. Due to the risk of progression into central precocious puberty or McCune Albright syndrome, long-term follow-up is necessary. CONCLUSION Peripheral precocious puberty should be managed in pediatric gynecology outpatient office and often subsides spontaneously. However, it can also be a sign of malignancy. In most cases, conservative therapy is preferred with medical treatment and surgery warranted in complicated cases. However, optimal treatment has not been established yet.
Collapse
|
11
|
Koltsidopoulos P, Chaidas K, Chlopsidis P, Skoulakis C. Granular cell (Abrikossoff) tumor in the head and neck: A series of 5 cases. Ear Nose Throat J 2016; 95:36-39. [PMID: 26829685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
We evaluated a series of 5 patients-3 men and 2 women, aged 39 to 70 years (mean: 54.4)-with a granular cell tumor (GCT) of the head and neck in an effort to better define the clinical presentation, imaging characteristics, and surgical management of this type of tumor. In all cases, the diagnosis was established by pathologic analysis. There were 2 cases of laryngeal GCT and 1 case each of GCT arising in the nostril, hypopharynx, and the tongue base. The clinical findings were variable, depending on the location and extent of each lesion. Four of these patients underwent endoscopic examination, and in 2 cases computed tomography was performed. Treatment included wide surgical excision of the lesion in all cases. Otolaryngologists should be familiar with this unusual tumor. Although an accurate preoperative diagnosis is extremely difficult to make, appropriate therapeutic intervention is associated with a cure rate that is quite high.
Collapse
Affiliation(s)
- Petros Koltsidopoulos
- ENT Department, General Hospital of Volos "Achillopoulio," Polimeri 134, 38222 Volos, Greece.
| | | | | | | |
Collapse
|
12
|
Bacalbasa N, Stoica C, Popa I, Mirea G, Balescu I. Endometrial Carcinoma Associated with Ovarian Granulosa Cell Tumors--A Case Report. Anticancer Res 2015; 35:5547-5550. [PMID: 26408724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ovarian granulosa cell tumors represent uncommon neoplasms with estrogen-secreting capacity. Due to their association with persistently increased levels of estrogen, modifications of the endometrial tissue ranging from hyperplasia to malignant degeneration may be encountered. We present the case of a 65-year-old patient who presented for post-menopausal vaginal bleeding. The endometrial biopsy raised the suspicion of an atypical endometrial hyperplasia and the patient was submitted to surgery. Histopathological studies of the specimen of total hysterectomy with bilateral adnexectomy revealed the presence of a well-differentiated endometrial carcinoma associated with a granulosa cell tumor of the ovary. In conclusion whenever a modified aspect of the endometrium is found preoperatively, attention should be given on other possible underlying modifications and a radical approach should be taken in consideration.
Collapse
Affiliation(s)
- Nicolae Bacalbasa
- Obstetrics and Gynecology Department Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Claudia Stoica
- General Surgery Department, Ilfov County Hospital, Bucharest, Romania
| | - Ileana Popa
- Pathology Department Coltea Clinical Hospital, Bucharest, Romania
| | - Gratiela Mirea
- General Surgery Department, Ilfov County Hospital, Bucharest, Romania
| | - Irina Balescu
- General Surgery Department, Ponderas Hospital, Bucharest, Romania
| |
Collapse
|
13
|
Ates S, Sevket O, Sudolmus S, Sonmez FC, Dansuk R. Granulosa cell tumor presenting with ovarian torsion and de novo borderline mucinous ovarian tumor in the contralateral ovary. EUR J GYNAECOL ONCOL 2015; 36:354-355. [PMID: 26189271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The authors report a case of 25-year-old women with a rare acute presentation of granulosa cell tumor (GCT) as an ovarian torsion. Right salpingoo-ooferectomy was performed. The pathological diagnosis was GCT One month after the surgery there was a three-cm ovarian cyst in the contralateral ovary and the tumor size increased to six cm in diameter in the following month. Serum inhibin-B levels progressively increased. Cystectomy was performed to contralateral ovary as frozen-section examination indicated mucinous tumor. Final histopathological examination revealed borderline mucinous tumor. Regarding her request, the patient was reoperated again and unilateral oophorectomy and hysterectomy were performed. Clinicians must be aware of the possibility of an underlying malignancy associated with adnexal torsion even in young patients. Frozen section will be helpful in order to avoid incomplete surgeries. Cyst rapidly growing in the ovary in young women should raise the suspicion of a de novo malignancy.
Collapse
|
14
|
Günyeli I, Bozkurt KK, Yalçın Y, Tatar B, Cerçi SS, Erdemoğlu E. Granulosa cell tumor and concurrent endometrial cancer with (18)F-FDG uptake. Hell J Nucl Med 2014; 17:153-155. [PMID: 25097899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/14/2014] [Indexed: 06/03/2023]
Abstract
The findings and the role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for the diagnosis of ovarian granulosa cell tumor (OG) are described. We present the pre-operative findings of (18)F-FDG PET/CT scan of a case of OG concurrent with endometrium cancer and endometrial hyperplasia, which revealed a 48mm mass demonstrating mild increased metabolic activity on the right ovary. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Frozen and paraffin-enbeded sections showed an encapsulated OG. There were few mitoses. There was concurrent atypical endometrial hyperplasia. In conclusion, we reported a case of an encapsulated OG, which showed mild uptake of the (18)F-FDG with concurrent endometrial cancer. There has been only one report of (18)F-FDG findings in primary ovarian granulosa cell tumor, similar to ours.
Collapse
Affiliation(s)
- Ilker Günyeli
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suleyman Demirel University, Isparta, 32000,Turkey.
| | | | | | | | | | | |
Collapse
|
15
|
Vera L, Accornero M, Mora M, Valenzano-Menada M, Minuto F, Giusti M. Increasing hirsutism due to a granulosa-cell tumor in a woman with polycystic ovary syndrome: case report and review of the literature. Gynecol Endocrinol 2013; 29:273-7. [PMID: 23327624 DOI: 10.3109/09513590.2012.743012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Granulosa-cell tumors (GCT), rare malignancies that arise from sex-cord stromal cells, account for less than 5% of ovarian tumors. These tumors present with an endocrine syndrome and mass signs. Surgery is the primary treatment approach. The risk of recurrence is more frequent in the juvenile-onset form. CASE REPORT We report the case of an obese 18-year-old Caucasian women with hirsutism and oligomenorrhea. Abdominal palpation revealed a voluminous firm mass. Hormonal evaluation documented severe hyperandrogenism. The ovary-specific tumor marker CA125 was elevated, whereas human-chorionic-gonadotropin was in the normal range. Abdominal imaging examination revealed a 19 cm mass in the left ovary. Twenty-four hours after removal of the mass, menstrual flow reappeared and androgens progressively normalized. Microscopically, the predominant pattern was one of uniform, bland, epithelioid to spindle-shaped cells. After three months, a significant weight loss was recorded, hirsutism had decreased slightly and oligomenorrhea reappeared. Δ4-Androstenedione levels remained elevated (4200 ng/L), whereas CA125 had normalized. In light of the pre-existing polycystic-ovary-syndrome (PCOS), the patient started estrogen-progestin treatment. CONCLUSION We report an interesting case of a woman with severe hirsutism due to GCT, and a history of oligomenorrhea caused by PCOS. After surgery, a dramatic clinical improvement was observed, whereas PCOS signs persisted.
Collapse
Affiliation(s)
- Lara Vera
- Department of Internal Medicine, National Institute for Cancer Research, Genoa, Italy
| | | | | | | | | | | |
Collapse
|
16
|
Bastu E, Akhan SE, Karamustafaoglu B, Gungor-Ugurlucan F, Sozen H, Iyibozkurt AC. Hemoperitoneum and acute abdomen caused by the rupture of ovarian granulosa cell tumor: a case report. EUR J GYNAECOL ONCOL 2013; 34:263-264. [PMID: 23967560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Granulosa cell tumors (GCT) constitute 70% of all ovarian sex-cord stromal tumors, which account for less than five percent of all ovarian carcinoma. The authors herein report a rare case of a ruptured GCT of the ovary in a 43-year-old female who was admitted to the emergency department with signs of acute abdomen.
Collapse
Affiliation(s)
- E Bastu
- Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul. Turkey.
| | | | | | | | | | | |
Collapse
|
17
|
Chaouch N, Mjid M, Brahem E, Zarrouk M, Racil H, Cheikh Rouhou S, Boudaya S, Hantous S, Zakhama B, Chabbou A. [Granulosa cell tracheal tumour: bronchoscopic treatment]. Rev Mal Respir 2012. [PMID: 23200596 DOI: 10.1016/j.rmr.2012.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
18
|
Pagnotti G, Adler BJ, Green DE, Chan ME, Frechette D, Shroyer KR, Beamer WG, Rubin J, Rubin CT. Low magnitude mechanical signals mitigate osteopenia without compromising longevity in an aged murine model of spontaneous granulosa cell ovarian cancer. Bone 2012; 51:570-7. [PMID: 22584009 PMCID: PMC3412935 DOI: 10.1016/j.bone.2012.05.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Revised: 04/19/2012] [Accepted: 05/04/2012] [Indexed: 12/26/2022]
Abstract
Cancer progression is often paralleled by a decline in bone mass, raising risk of fracture. Concerns persist regarding anabolic interventions for skeletal protection, as these may inadvertently exacerbate neoplastic tissue expansion. Given bone's inherent mechanosensitivity, low intensity vibration (LIV), a mechanical signal that encourages osteoblastogenesis, could possibly slow cancer-associated bone loss, but this goal must be achieved without fostering disease progression. Seventy 12w female F1-SWRxSWXJ-9 mice, a strain prone to developing granulosa cell tumors, were randomized into baseline control (BC: n=10), age-matched control (AC: n=30), and LIV (n=30), which received mechanical signals (90Hz @ 0.3g) for 15m/day, 5 day/w over the course of 1 year. Survival curves for AC (10 died) and LIV (8 died) followed similar trends (p=0.62), indicating longevity was unperturbed by LIV. At 1 year, bone volume of proximal tibiae in LIV mice was 25% greater than AC (p<0.02), while bone volume of L5 vertebrae was 16% higher in LIV over AC (p<0.02). Primary lesions and peripheral metastases were apparent in both LIV and AC; however, overall tumor incidence was approximately 30% less in LIV (p=0.27) and, when disease was evident, involved fewer organ systems (p=0.09). Marrow-derived mesenchymal stem cells (MSC) were 52% lower (p<0.01) in LIV, and 31% lower (p=0.08) in mice lacking pathology, suggesting higher MSC levels in this model of cancer susceptibility may have contributed to tumor progression. These experiments indicate that LIV helps protect bone mass in mice inherently susceptible to cancer without compromising life expectancy, perhaps through mechanical control of stem cell fate. Further, these data reflect the numerous system-level benefits of exercise in general, and mechanical signals in particular, in the preservation of bone density and the suppression of cancer progression.
Collapse
Affiliation(s)
- Gabriel Pagnotti
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-2580
| | - Benjamin J. Adler
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-2580
| | - Danielle E. Green
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-2580
| | - Meilin E. Chan
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-2580
| | - Danielle Frechette
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-2580
| | - Kenneth R. Shroyer
- Department of Pathology, Stony Brook University, Stony Brook, NY, 11794-2580
| | | | - Janet Rubin
- Department of Medicine, University of North Carolina, Chapel Hill, NC 27599
| | - Clinton T. Rubin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-2580
| |
Collapse
|
19
|
Dilbaz B, Karadag B, Hizli D, Dilbaz S. Ruptured ovarian granulosa cell tumor as a cause of hemoperitoneum. Saudi Med J 2012; 33:912-913. [PMID: 22886129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Berna Dilbaz
- Department of Obstetrics & Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | | | | | | |
Collapse
|
20
|
Newell S, Overton C. Postmenopausal bleeding should be referred urgently. Practitioner 2012; 256:13-2. [PMID: 22662514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Postmenopausal bleeding is an episode of bleeding 12 months or more after the last menstrual period. It occurs in up to 10% of women aged over 55 years. All women with postmenopausal bleeding should be referred urgently. Endometrial cancer is present in around 10% of patients; most bleeding has a benign cause. The peak incidence for endometrial carcinoma is between 65 and 75 years of age. Causes of postmenopausal bleeding include: endometrial carcinoma; cervical carcinoma; vaginal atrophy; endometrial hyperplasia +/- polyp; cervical polyps; hormone-producing ovarian tumours; haematuria and rectal bleeding. The aim of assessment and investigation of postmenopausal bleeding is to identify a cause and exclude cancer. Assessment should start by taking a detailed history, with identification of risk factors for endometrial cancer, as well as a medication history covering use of HRT, tamoxifen and anticoagulants. Abdominal and pelvic examinations should be carried out to look for masses. Speculum examination should be performed to see if a source of bleeding can be identified, assess atrophic changes in the vagina and look for evidence of cervical malignancy or polyps. Ultrasound scan and endometrial biopsy are complementary. Ultrasound scan can define endometrial thickness and identify structural abnormalities of the uterus, endometrium and ovaries. Endometrial biopsy provides a histological diagnosis. The measurement of endometrial thickness aims to identify which women with postmenopausal bleeding are at significant risk of endometrial cancer. If the examination is normal, the bleeding has stopped and the endometrial thickness is < 5 mm on transvaginal ultrasound scan, no further action need be taken.
Collapse
|
21
|
Paternoster M, Graziano V, Settimi A, Di Lorenzo P, Alicchio F, Esposito C. Medico-legal observations concerning a mortal case of granulosa cell tumor of the ovary in an 8-month-old infant. J Pediatr Surg 2011; 46:1679-82. [PMID: 21843743 DOI: 10.1016/j.jpedsurg.2011.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 04/08/2011] [Accepted: 04/11/2011] [Indexed: 11/19/2022]
|
22
|
Sarikaya D, Varan O, Ozen G, Dogan E, Altundag K. Late recurrence of granulosa cell tumor of the ovary with synchronous gastric signet-ring cell carcinoma. J BUON 2010; 15:799-800. [PMID: 21229651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
23
|
Nakaigawa N, Komatsu R, Hamada K, Kamata K, Ozaki M. [Perioperative management of a patient with deep vein thrombosis caused by estrogen producing granulosa cell tumor of the ovary]. Masui 2010; 59:224-227. [PMID: 20169964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We experienced perioperative management of a woman with large thrombi in femoral veins caused by estrogen producing ovarian tumor. At presentation, serum estradiol level was extremely high. Time constraint due to rapid expansion of the tumor did not allow us a trial of preoperative anti-coagulation. We placed a temporary IVC filter and proceeded with operation. As catastrophic pulmonary embolism could occur even with the presence of a filter, we prepared for institution of cardiopulmonary bypsss and pulmonary embolectomy via full sternotomy. We monitored arterial pressure based-cardiac output for immediate detection of pulmonary embolism. Postoperatively, serum estradiol level declined to normal range by postoperative day 7, and thrombi dissolved with anticoagulation therapy with warfarin and heparin without recurrence. In this case, surgery without preoperative anticoagulation was considered to pose extreme risk of perioperative pulmonary embolism. However, we considered that the thrombi would disolve by the removal of the tumor because estradiol production was the primary cause of thrombi. With above mentioned perioperative approach, the patient was managed uneventfully.
Collapse
|
24
|
Datta M, Winter-Roach BA, Fitzgerald C. Secondary amenorrhoea associated with an isolated elevated serum leuteinising hormone: An unusual presentation of a granulosa cell tumour. J OBSTET GYNAECOL 2009; 26:830-2. [PMID: 17130057 DOI: 10.1080/01443610600994858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M Datta
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester, UK.
| | | | | |
Collapse
|
25
|
Moodley M, Moodley J. Human immunodeficiency virus (HIV) infection and ovarian granulosa cell tumour in association with endocrine manifestations. J OBSTET GYNAECOL 2009; 24:185-6. [PMID: 14766468 DOI: 10.1080/01443610410001653353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M Moodley
- Gynaecology-Oncology Unit, Nelson R Mandela School of Medicine, Durban, South Africa.
| | | |
Collapse
|
26
|
Van Holsbeke C, Domali E, Holland TK, Achten R, Testa AC, Valentin L, Jurkovic D, Moerman P, Timmerman D. Imaging of gynecological disease (3): clinical and ultrasound characteristics of granulosa cell tumors of the ovary. Ultrasound Obstet Gynecol 2008; 31:450-456. [PMID: 18338427 DOI: 10.1002/uog.5279] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To describe the clinical and ultrasound characteristics of granulosa cell tumors (GCTs) of the ovary, and to define the ultrasound appearance of GCTs based on pattern recognition. METHODS Databases of four gynecological ultrasound centers were searched to identify patients with histologically proven GCTs who had undergone a standard preoperative ultrasound examination. RESULTS A total of 23 women with confirmed GCT were identified. Twelve (52%) women were postmenopausal, nine (39%) were of fertile age and two (9%) were prepubertal. Clinical symptoms were abdominal distension (7/23, 30%), pain (5/23, 22%) and irregular vaginal bleeding (6/23, 26%). Seven patients (30%) were asymptomatic. Endometrial pathology was found in 54% (7/13) of the patients from whom endometrial biopsies were taken. On ultrasound scan 12/23 (52%) masses were multilocular-solid, 9/23 (39%) were purely solid, one mass (4%) was unilocular-solid and one mass was multilocular (4%). Multilocular and multilocular-solid cysts typically contained large numbers of small locules (> 10). The echogenicity of the cyst content was most often mixed (6/16, 38%) or low level (7/16, 44%). Papillary projections were found in only four women (17%). The GCTs were large tumors with a median largest diameter of 102 (range, 37-242) mm and manifested moderate or high color content at color Doppler examination (color score 3 in 13/23 tumors (57%); color score 4 in 8/23 tumors (35%)). CONCLUSIONS At ultrasound examination, most GCTs are large multilocular-solid masses with a large number of locules, or solid tumors with heterogeneous echogenicity of the solid tissue. Hemorrhagic components are common and increased vascularity is demonstrated at color/power Doppler ultrasound examination. The hyperestrogenic state that is created by the tumor often causes endometrial pathology with bleeding problems as a typical associated symptom.
Collapse
Affiliation(s)
- C Van Holsbeke
- Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, Belgium
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Affiliation(s)
- G R Alexander
- Goulburn Valley Equine Hospital, 905 Goulburn Valley Highway, Congupna, Victoria 3633
| | | | | | | |
Collapse
|
28
|
Nasu K, Fukuda J, Yoshimatsu J, Takai N, Kashima K, Narahara H. Granulosa cell tumor associated with secondary amenorrhea and serum luteinizing hormone elevation. Int J Clin Oncol 2007; 12:228-30. [PMID: 17566848 DOI: 10.1007/s10147-006-0640-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 11/09/2006] [Indexed: 10/23/2022]
Abstract
Adult granulosa cell tumors (GCTs) are the most common type of ovarian sex cord tumors. Menstrual irregularity, menorrhagia, or even secondary amenorrhea is frequently observed in premenopausal women bearing GCTs with hormonal activity. We report herein a case of GCT in a patient presenting with secondary amenorrhea and serum luteinizing hormone elevation. A 28-year-old primigravid Japanese woman was admitted complaining of secondary amenorrhea of 2 years' duration. Pelvic examination, transvaginal ultrasonography, and magnetic resonance imaging demonstrated a left ovarian tumor 4 cm in diameter. Serum hormone assays revealed a follicle-stimulating hormone level of 4.8 mIU/ml, luteinizing hormone (LH) of 35.8 mIU/ml, estradiol of 24 pg/ml, progesterone of 1.6 ng/ml, and testosterone of 40 ng/dl. A left salpingo-oophorectomy was performed. The tumor was diagnosed as an adult-type GCT stage IIb (FIGO [International Federation of Obstetricians and Gynecologists], 1988). Spontaneous menstruation occurred soon after the surgery. Serum levels of LH also decreased to normal levels and showed cyclic changes during the menstrual cycle. Subsequently, the patient conceived and delivered a healthy female baby. The tumor recurred in the pelvis 50 months after the initial conservative surgery, with elevated serum LH levels of 36.0 mIU/ml and amenorrhea. The patient was treated by hysterectomy, right salpingo-oophorectomy, omentectomy, paraaortic and pelvic lymphadenectomy, and low anterior resection of the recto-sigmoid colon. Her hormone levels progressed to the postmenopausal state after this surgery. Although LH elevation in patients with GCT is rare and its mechanism is unknown, monitoring of serum LH may provide an additional tumor marker after conservative surgery in such patients.
Collapse
Affiliation(s)
- Kaei Nasu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Hasama-machi, Oita, 879-5593, Japan.
| | | | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
- James Haan
- R. Adams Cowley Shock Trauma Center, University of Maryland, MD 21201-1595, USA.
| | | | | |
Collapse
|
30
|
Mitrović K, Zdravković D, Milenković T, Sedlecki K, Stanković Z. [Ovarian cysts and tumors as the cause of isosexual pseudoprecocious puberty]. SRP ARK CELOK LEK 2006; 134:305-9. [PMID: 17009609 DOI: 10.2298/sarh0608305m] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Precocious puberty in girls is generally defined as appearance of secondary sexual characteristics before eight years of age. Menarche before the ninth birthday may serve as an additional criterion. Precocious puberty is divided in central precocious puberty and pseudoprecocious puberty. Central precocious puberty (GnRH dependent) occurs because of premature activation of hypothalamic-pituitary-gonadal axis and activity of gonadotrophins. Pseudoprecocious puberty (GnRH independent) is caused by activity of sexual steroids that are not the result of gonadotrophin activity. OBJECTIVE Objective of our study was to examine the etiology, clinical and laboratory manifestations of isosexual pseudoprecocious puberty in girls. METHOD In the period between 1995 and 2004, clinical and laboratory sings of 34 girls with precocious puberty were studied at the Endocrine Department of the Institute of Mother and Child Health Care of Serbia. Initial evaluations included height measurement, staging of puberty, bone age assessment and pelvic ultrasound. Important diagnostic sonographic parameters of precocious puberty were the volumes of ovaries and uterus as well as ovarian structure. The initial hormonal evaluation included measuring of plasma oestradiol, luteinizing hormone (LH) and follicle stimulating hormone (FSH). The luteinizing hormone releasing hormone (LHRH) stimulation test was used to evaluate LH and FSH responsiveness (60 microg/m2 LHRH-Relefact LHRH, Ferring). Blood samples were collected at 0, 20 and 60 minutes. Basal and GnRH stimulated LH and FSH were determined by immunoradiometric assay. Estradiol concentration was measured using the fluoroimmunometric assay. RESULTS Thirty-four girls aged 6 months to 9 years (mean age 4.5 years) with precocious puberty were studied during the period of 9 years. Eleven girls presented with breast development, six with vaginal bleeding and seventeen with signs of puberty. On the basis of clinical signs, bone age, estradiol levels and LHRH test, premature thelarche was diagnosed in eleven patients (32.4%), premature menarche in six (17.6%) and central precocious puberty in ten girls (29.4%). Seven girls (20.6%) presented with pseudoprecocious puberty. Pelvic ultrasound examination revealed unilateral ovarian cysts in six patients and granulosa cell tumor in one. Elevated estrogen serum levels and failure of gonadotropin responses after gonadotropin releasing hormone were the classical findings in patients with isosexual pseudoprecocious puberty during the acute period of disease. In four patients, the cyst decreased spontaneously after several months, while in two patients, the cyst was removed by laparotomy. Surgical treatment was performed in a patient with granulosa cell tumor. CONCLUSION Our work demonstrates that autonomous functional ovarian follicle cyst is the most often cause of isosexual pseudoprecocious puberty. Short period of observation is suggested because the cyst can resolve spontaneously. On the other hand, juvenile granulosa cell tumor, as highly malignant tumor, should be removed as soon as diagnosis is established.
Collapse
|
31
|
Guo H, Keefe KA, Kohler MF, Chan JK. Juvenile granulosa cell tumor of the ovary associated with tuberous sclerosis. Gynecol Oncol 2006; 102:118-20. [PMID: 16516278 DOI: 10.1016/j.ygyno.2006.01.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Revised: 12/28/2005] [Accepted: 01/03/2006] [Indexed: 12/01/2022]
Abstract
BACKGROUND Tuberous sclerosis is a neurocutaneous syndrome characterized by benign tumors that can affect many organs. Juvenile granulosa cell tumors of the ovary are rare neoplasms that typically occur in the first three decades of life and have excellent prognosis for early-staged disease. CASE REPORT We report the first case of an 8-year-old white female with tuberous sclerosis and juvenile granulosa cell tumor of the ovary. She presented with a 20 x 22 cm pelvic mass and received a right salpingo-oophorectomy. Three months later, she recurred and underwent a left salpingo-oophorectomy, lymphadenectomy, and omentectomy followed by four cycles of Bleomycin, Etoposide, and Cisplatin chemotherapy. She is currently free of disease 8 years after her recurrence. CONCLUSION Treatment options and a review of the literature pertaining to juvenile ovarian granulosa cell tumors and tuberous sclerosis are discussed.
Collapse
Affiliation(s)
- Hongyan Guo
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford University School of Medicine, 300 Pasteur Drive HH333, CA 94305, USA
| | | | | | | |
Collapse
|
32
|
Kabaca C, Karateke A, Gurbuz A, Cesur S. Androgenic adult granulosa cell tumor in a teenager: a case report and review of the literature. Int J Gynecol Cancer 2006; 16 Suppl 1:368-74. [PMID: 16515626 DOI: 10.1111/j.1525-1438.2006.00513.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The clinicopathologic findings of the third case of androgenic adult granulosa cell tumor in patients younger than 15 years was presented and discussed in the light of the literature. A patient complaining of secondary amenorrhea and hirsutism with elevated levels of plasma total testosterone, dehydroepiandrosterone sulfate, free androgen index and serum inhibin A, and a left ovarian septated, cystic mass was admitted to the hospital. The inhibin A level was within normal levels in the first month postoperatively. Inhibin A could be a tumor marker of utmost importance particularly in patients with androgenic or hyperestrogenic symptoms, especially in cases where benign criteria are abundant such as young age, nonincreased levels of classic tumor markers, and ultrasonographic appearance without any suspicion of malignancy.
Collapse
Affiliation(s)
- C Kabaca
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Education And Research Hospital, Uskudar, Istanbul, Turkey.
| | | | | | | |
Collapse
|
33
|
Paula LCPD, Zen VL, Czepielewski MA. [Granulosa-stromal tumor of the ovary: a case of mixed germ cell-cord stromal tumor of the ovary with endocrinological considerations]. Arq Bras Endocrinol Metabol 2006; 49:776-83. [PMID: 16444360 DOI: 10.1590/s0004-27302005000500018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Granulosa-stromal tumors comprise 5 to 8% of all primary ovarian neoplasms. The first clinical manifestation is precocious puberty in most prepuberal patients. We report a case of mixed germ cell-cord stromal tumor of ovary in a 7.2 years old girl, who presented with isosexual pseudo-precocious puberty of progressive outcome. Serum testosterone, estradiol and 17alphaOH-progesterone levels were increased. Abdominal-pelvic ultrasound revealed a right ovarian mass. Unilateral salpingo-oophorectomy was performed with complete resection of the tumor. The patient is well 7 years after surgery with normal pubertal and growth development and no signs of tumor relapse. We review the clinical manifestations of ovarian tumors, classification and staging of sex cord-stromal tumors, follow-up, tumor markers, treatment and prognosis.
Collapse
|
34
|
Pradhanang V, Ghimire S. Hirsutism: a rare presentation of an adult granulosa cell tumor of ovary. Nepal Med Coll J 2005; 7:152-4. [PMID: 16519088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Ovarian tumor with clinical manifestations like hirsutism, atrophic uterus, flattened breasts and absence of post-menopausal bleeding and atrophic endometrium was reported as an adult granulosa cell tumor (GCT) on histopathological examination, is discussed.
Collapse
Affiliation(s)
- Vidya Pradhanang
- Department of Obstetrics and Gynaecology, Nepal Medical College Jorpati-7, Kathmandu.
| | | |
Collapse
|
35
|
Affiliation(s)
- Meral Koyuncuoglu
- Department of Pathology, Dokuz Eylul University School of Medicine, Inciralti, Izmir, Turkey
| | | | | | | | | |
Collapse
|
36
|
Abstract
Juvenile granulosa cell tumours (JGCT) represent a rare malignancy in childhood and their laparoscopic resection has not been advocated yet. We report on a 6-year-old girl with signs of precocious pseudo-puberty and an abdominal tumour. Work-up revealed premature thelarche, vaginal discharge, elevated estrogen levels, and a solid tumour in the lower pelvis (6 x 4 x 3 cm in MRI). The girl underwent laparoscopy (3 ports, 5-mm instruments), during which a non-invasive, mobile tumour of the left ovary was found. Since all margins of resection could be clearly identified, salpingo-oophrectomy was performed, using the harmonic scalpel for dissection and 5-mm clips to ligate the fallopian tube. Histopathology revealed a JGCT with an intact capsule (FIGO 1 a) which required no further chemotherapy. Within 3 months postoperatively the girl's signs of precocious puberty had resolved and at present, after a follow-up of more than 3 years, there is no evidence of tumour recurrence. Minimally invasive surgery of solid ovarian tumours in children remains controversial. However in the present case, laparoscopic resection did not compromise the surgical and oncological safety.
Collapse
Affiliation(s)
- H Till
- Department of Paediatric Surgery, Dr. von Hauner Children's Hospital, University of Munich, Munich, Germany.
| | | |
Collapse
|
37
|
Kalfa N, Patte C, Orbach D, Lecointre C, Pienkowski C, Philippe F, Thibault E, Plantaz D, Brauner R, Rubie H, Guedj AM, Ecochard A, Paris F, Jeandel C, Baldet P, Sultan C. A nationwide study of granulosa cell tumors in pre- and postpubertal girls: missed diagnosis of endocrine manifestations worsens prognosis. J Pediatr Endocrinol Metab 2005; 18:25-31. [PMID: 15679066 DOI: 10.1515/jpem.2005.18.1.25] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are very few data on the natural history of ovarian granulosa cell tumors (OGCT) in children. The aim of this study was to determine whether early recognition and diagnosis of the initial endocrine signs could improve the outcome of these tumors. METHODS In a nationwide study from 1990 to 2004, we analyzed the clinical, biological and pathologic data from 40 pre- and postpubertal girls presenting an OGCT. RESULTS 1. Among the prepubertal girls (n = 29), 17 OGCTs were diagnosed on the basis of precocious pseudopuberty. None of the 17 girls had a peritoneal spread of the tumor (100% FIGO stage Ia). Diagnosis based on a tumoral or acute abdomen (12 cases) was associated with frequent intraperitoneal ruptures of the tumor (50%) and a risk of relapse (2 cases). Of the eight girls who had had a misdiagnosed precocious pseudopuberty, five had a pre- or perioperative tumoral rupture. 2. Among the postpubertal girls (n = 11), endocrine manifestations such as secondary amenorrhea or virilization had been underevaluated in three of them and the diagnosis was established from a tumoral abdomen. This clinical presentation was associated with frequent ruptures of the mass in the peritoneum (80%) and a higher risk of recurrence (30%). 3. A delayed diagnosis of OGCT despite previous endocrine signs (11 cases; 8 pre- and 3 postpubertal) was associated with a high risk of pre- or peri-operative peritoneal tumor spreading (70% FIGO stage Ic or IIc, p <0.05). The mean delay for diagnosis ranged from 3 to 11 months. CONCLUSION This study highlights the critical role of early diagnosis of OGCT in pre- and postpubertal girls, particularly at the first seemingly banal signs of endocrine disorder. Peritoneal spread of the tumor may thereby be prevented, which improves the prognosis.
Collapse
Affiliation(s)
- N Kalfa
- Hôpital Arnaud de Villeneuve, CHU Montpellier, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Kurihara S, Hirakawa T, Amada S, Ariyoshi K, Nakano H. Inhibin-producing ovarian granulosa cell tumor as a cause of secondary amenorrhea: Case report and review of the literature. J Obstet Gynaecol Res 2004; 30:439-43. [PMID: 15566459 DOI: 10.1111/j.1447-0756.2004.00231.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report the case of 31-year-old patient with an inhibin B-secreting granulosa cell tumor of the left ovary who presented with secondary amenorrhea. Preoperative serum hormonal levels were as follows: follicle-stimulating hormone (FSH) 0.3 mIU/mL, luteinizing hormone (LH) 9.81 mIU/mL, estradiol 142.0 pg/mL and inhibin B 2429 pg/mL. Gonadotropin-releasing hormone (GnRH) test revealed no FSH response and a normal LH response. After removal of the tumor, the levels of FSH and inhibin B returned to within the normal range, and regular menses resumed 27 days postoperatively. In premenopausal women, secondary amenorrhea may be the initial manifestation of granulosa cell tumor. A low FSH level coupled with normal levels of E2 and LH, the inhibition of the FSH response to GnRH and an elevated inhibin level suggest the presence of an inhibin-secreting ovarian tumor and also rule out the possibility of isolated FSH deficiency.
Collapse
Affiliation(s)
- Shuichi Kurihara
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, Japan
| | | | | | | | | |
Collapse
|
39
|
Masseau I, Fecteau G, Desrochers A, Francoz D, Lanthier I, Vaillancourt D. Hemoperitoneum caused by the rupture of a granulosa cell tumor in a Holstein heifer. Can Vet J 2004; 45:504-6. [PMID: 15283520 PMCID: PMC548634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
A case of a hemoperitoneum caused by the rupture of a granulosa cell tumor in a 9-month-old Holstein heifer is reported. Management of hemorrhagic shock in cattle is discussed.
Collapse
Affiliation(s)
- Isabelle Masseau
- Département des sciences cliniques, Centre Hospitalier Universitaire Vétérinaire, Université de Montréal, 3200 Sicotte, Ste-Hyacinthe, Quebec
| | | | | | | | | | | |
Collapse
|
40
|
Chan LF, Storr HL, Scheimberg I, Perry LA, Banerjee K, Miraki-Moud F, Camacho-Hübner C, Savage MO. Pseudo-precocious puberty caused by a juvenile granulosa cell tumour secreting androstenedione, inhibin and insulin-like growth factor-I. J Pediatr Endocrinol Metab 2004; 17:679-84. [PMID: 15198302 DOI: 10.1515/jpem.2004.17.4.679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a female child who presented at age 3.92 years with a 2-year history of consonant pubertal development caused by a large right-sided ovarian juvenile granulosa cell tumour (JGCT). Although JGCTs causing pseudo-precocious puberty have been previously described, they remain rare and endocrine data are often incomplete. In this case the tumour was associated with raised serum oestradiol, androstenedione, inhibin and IGF-I. Histological changes were consistent with JGCT. Immunohistochemical studies revealed positive reactivity to MIC-2, inhibin, melan A, IGF-I and IGFBP-2.
Collapse
Affiliation(s)
- L F Chan
- Department of Paediatric Endocrinology, St Bartholomew's and The Royal London School of Medicine and Dentistry, London, UK
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
Granulosa cell tumor of the ovary is a rare form of ovarian cancer in children. An 11-year-old girl was admitted with complaints of galactorrhea and abdominal mass. Abdomino-pelvic ultrasound and computed tomography revealed an ovarian tumor. Her prolactine and estradiol levels were increased but luteinizing hormone and follicle-stimulating hormone were decreased. An exploratory laparotomy revealed a giant solid mass, which was completely removed and determined as juvenile granulosa cell tumor. The clinical, hormonal, and radiological findings and the therapy of galactorrhea associated with granulosa cell tumor in a child are discussed. To our knowledge, this is first time it has been described in childhood.
Collapse
Affiliation(s)
- Yavuz Koksal
- Department of Pediatrics, Selcuk University, Meram Medical Faculty, Konya, Turkey.
| | | | | | | | | | | |
Collapse
|
42
|
Guzzo T, Gerstein M, Mydlo JH. Granulosa Cell Tumor of the Contralateral Testis in a Man with a History of Cryptorchism. Urol Int 2004; 72:85-7. [PMID: 14730174 DOI: 10.1159/000075281] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2001] [Accepted: 05/08/2002] [Indexed: 11/19/2022]
Abstract
We report a case of adult-type testicular granulosa cell tumor in a 33-year-old man with a history of cryptorchism of the contralateral testis as well as Crohn's disease. The tumor was identified as a 1 x 1 x 1 cm mass on baseline ultrasound evaluation. CT evaluation of the patient revealed extensive mesenteric adenopathy, most likely secondary to his history of Crohn's disease.
Collapse
Affiliation(s)
- Thomas Guzzo
- Department of Urology, Temple University School of Medicine, Philadelphia, PA 19140, USA
| | | | | |
Collapse
|
43
|
Abstract
Perimortem caesarean section is the intervention of choice for unresponsive cardiorespiratory arrest during the third trimester of pregnancy. We present a case of emergent surgical intervention in an arrested patient with an abdominopelvic mass, which revealed a ruptured granulosa cell ovarian neoplasm with haemoperitoneum.
Collapse
Affiliation(s)
- Philip Kaye
- Emergency Department, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
| | | | | | | |
Collapse
|
44
|
Saeed GA, Farooq N. Precocious pseudopuberty due to juvenile granulosa cell tumor. J Coll Physicians Surg Pak 2003; 13:287-8. [PMID: 12757681 DOI: 05.2003/jcpsp.287288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2002] [Accepted: 12/28/2002] [Indexed: 11/03/2022]
Abstract
A case of precocious puberty occurring in a young girl is presented. Vaginal bleeding and secondary sexual characteristics had occurred at 7 years of age associated with an abdominal mass. These findings were due to a functional juvenile granulosa cell tumor in the right ovary. Right adenectomy was performed. Histopathology was confirmatory.
Collapse
Affiliation(s)
- Gulshan Ara Saeed
- Department of Gynaecology/Obstetrics, Railway Hospital, Islamic International Medical College, Rawalpindi.
| | | |
Collapse
|
45
|
Affiliation(s)
- K Yoshino
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Sakai City, Japan.
| | | | | | | | | |
Collapse
|
46
|
Gasmi M, Jouini R, Sahnoun L, Belghith M, Mekki M, Nouri A. [Early pseudopuberty revealing juvenile granulosa tumor of the ovary]. Presse Med 2003; 32:701. [PMID: 12762293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
|
47
|
Honda T, Fukasawa H, Hashi A, Minai M, Hirata S, Hoshi K. Androgenic adult granulosa cell tumour with prolongation of the activated partial thromboplastin time in a 29 year old woman. BJOG 2003; 110:433-5. [PMID: 12699808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- Tsuyoshi Honda
- Department of Obstetrics, Yamanashi Medical University, Tamaho-cho, Nakakoma-gun, Japan
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
Malignant ovarian tumors are responsible for 2-3% of all cases of precocious pseudopuberty (PP) in girls. The most common forms of ovarian tumors presenting as PP are the granulosa cell tumors (GCT). The clinical and pathological features of granulosa cell tumors that occur frequently in young girls, so-called juvenile granulosa cell tumors (JGCT), differ histologically from those occurring in adults. As a cause of PP in young girls, adult type granulosa cell tumors (AGCT) are extremely rare. We report a 6 year-old girl presenting with early breast development and vaginal bleeding due to a well encapsulated ovarian tumor. Microscopic features of the resected tumor were characteristic of AGCT.
Collapse
Affiliation(s)
- Pinar Isguven
- Division of Pediatric Endocrinology, Department of Pediatrics, SSK Goztepe Educational Hospital, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
49
|
Patterson MM, Rogers AB, Schrenzel MD, Marini RP, Fox JG. Alopecia attributed to neoplastic ovarian tissue in two ferrets. Comp Med 2003; 53:213-7. [PMID: 12784857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Ferrets with adrenal gland dysfunction have alopecia as their most common clinical sign of disease. Two cases of alopecia in neutered female ferrets are reported that were associated instead with neoplastic tissue found at the site of an ovarian pedicle. Androstenedione and 17-hydroxyprogesterone, but not estradiol, concentrations were high in both ferrets. Following surgical resection of the abnormal tissue in one ferret, the high hormone values decreased quickly and hair regrowth ensued. In both cases, histologic examination revealed features consistent with classical sex cord-stromal (gonadostromal) tumors: prominent spindle cells, along with polyhedral epithelial cells and cells with vacuolated cytoplasm. Although similiar cell types have been described in the adrenal glands of ferrets with adrenal-associated endocrinopathy, an ovarian origin for the current neoplasms is considered likely on the basis of their anatomic location; accessory adrenal tissue has only been described close to an adrenal gland or in the cranial perirenal fat of ferrets. Immunohistochemical analysis, using an antibody against Mullerian-inhibiting substance, failed to prove definitively the source of the steroidogenic cells.
Collapse
Affiliation(s)
- Mary M Patterson
- Division of Comparative Medicine, Massachuetts Institute of Technology, Cambridge 02139, USA
| | | | | | | | | |
Collapse
|
50
|
Krishnan A, Murdock C, Allard J, Cisar M, Reid E, Nieman L, Segars J. Pseudo-isolated FSH deficiency caused by an inhibin B-secreting granulosa cell tumour: case report. Hum Reprod 2003; 18:502-5. [PMID: 12615814 DOI: 10.1093/humrep/deg124] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Isolated FSH deficiency due to a mutation in the FSHbeta subunit is characterized by an extremely low serum FSH concentration. We report a patient who presented with an FSH of 0.8 mIU/ml and infertility associated with anovulation. Endocrinological assessment and immunohistochemistry revealed that a granulosa cell tumour was secreting inhibin B and suppressing FSH; however, LH and estradiol were within their normal ranges. Upon removal of the tumour, inhibin B decreased and FSH levels rose to normal values. The patient subsequently conceived and delivered successfully. Based on this case and on those previously described in the literature, we suggest that inhibin B levels should be evaluated in anovulatory patients having a clinical presentation consistent with functional hypothalamic amenorrhoea and very low to normal values of FSH.
Collapse
Affiliation(s)
- A Krishnan
- Pediatric & Reproductive Endocrinology Branch, NICHD/National Institutes of Health, Building 10, Bethesda, MD 20892, USA
| | | | | | | | | | | | | |
Collapse
|