Search

Juvenile granulosa cell tumor (JGCT) is an extremely rare ovarian tumor that has been associated with Maffucci syndrome. It both secretes hormone and has been postulated to grow in response to hormone. We present a case of a 33-year-old G1P0 asymptomatic woman with a history of Maffucci syndrome found to have a left adnexal mass on routine ultrasonography at 13 weeks gestation. This case demonstrates the sonographic and magnetic resonance imaging (MRI) features of JGCT, as well as the natural progression of the tumor during pregnancy. A follow-up ultrasound 3 weeks after initial diagnosis demonstrated marked growth in size and vascularity of the tumor, prompting unilateral salpingo-oophorectomy. Histopathological findings confirmed the diagnosis of JGCT., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Case History: A 14-year-old Thoroughbred mare was presented for evaluation of a rapidly enlarging ovary at 73 days gestation. The mare's owner reported behavioural changes in the mare since she returned from stud, notably aggression towards other horses., Clinical Findings: Transrectal palpation and ultrasonography of the reproductive tract revealed a viable pregnancy, an enlarged, multiloculated right ovary, and a normal-sized left ovary with a corpus luteum present. Concentrations of inhibin and testosterone in serum were 13.8 ng/mL and 1,150 pg/mL, respectively, being markedly higher than reference ranges. Concentration of progesterone was 4.5 ng/mL, consistent with the presence of functional luteal tissue. A presumptive diagnosis of a granulosa theca cell tumour (GTCT) was made, and the ovary was surgically removed. Histopathological examination of the removed ovary confirmed a benign GTCT. At 31 days after surgery concentrations of inhibin in serum had decreased 18-fold, and testosterone had decreased 10-fold. Pregnancy was reconfirmed at 115 days gestation by rectal palpation and transrectal ultrasonography., Diagnosis: Granulosa theca cell tumour associated with elevated concentrations of inhibin and testosterone in serum., Clinical Relevance: While ovarian enlargement and aggressive behaviour may be considered normal in some pregnant mares, a GTCT should be included as a differential diagnosis. Measurement of concentrations of inhibin and testosterone in serum are useful to support a presumptive diagnosis of GTCT in mares.

Introduction: Granulosa cell tumors (GCTs) are extremely rare tumors and are divided into 2 types: adult (AGCT) and juvenile (JGCT). The JGCTs represent only 5% of all cases. The incidence of ovarian carcinoma diagnosed during pregnancy varies about 0.0179 to 0.11 per 1000 pregnancies., Case: A 24-year-old woman at 12 weeks and 3 days of pregnancy was admitted to the authors' hospital due to a pelvic mass. Surgical exploration revealed a smooth, solid, mobile and well-encapsulated left ovarian mass. Histological and immunohistochemical findings led to the diagnosis of a well-differentiated JGCT. Pregnancy continued uncomplicated and she delivered a healthy baby girl at 37 weeks gestation. About 9 months after the original diagnosis, the patient showed no evidence of disease., Conclusion: Treatment options and a review of the literature related to JGCTs are discussed.

Introduction: Metastatic adult granulosa cell tumor of the ovary is rarely encountered with pregnancy., Case Report and Results: Primigravida (26 years) presented at 20 weeks of gestation with acute abdomen and clinical evidence of supraclavicular lymphadenopathy and ascites. She was diagnosed of adult granulosa cell tumor (AGCT) of the right ovary following right salpingoophrectomy done 1 month prior to conception. Fine needle aspiration cytology of supraclavicular lymph node, revealed it to be a metastatic AGCT. Chemotherapy was given antepartum and she delivered a healthy preterm baby at 30 weeks. Subsequently, she had optimal debulking surgery following 6 cycles of cisplatin-based chemotherapy. Baby at 10 months of age was with normal milestones., Conclusions: The case is an unusual presentation of metastatic adult granulosa cell tumor at child bearing age. Although rapidly progressing, successful prolongation of pregnancy till 30 weeks of gestation was possible with the judicious use of chemotherapy. Fetal and maternal outcomes were favorable.

Granulosa cell tumors (GCT) of the ovary account for 2% to 5% of all ovarian tumors and typically demonstrate an indolent clinical course. For a young woman with stage IA disease who wishes to preserve fertility, conservative surgery with laparoscopic techniques can be a safe and effective method. Three patients with clinical presumptive stage IA GCT of the ovary were initially treated with conservative laparoscopic surgery with intraoperative rupture of the tumor. On repeat surgical exploration, all 3 patients were found to have peritoneal disease. Postoperative chemotherapy was required. Several important aspects of laparoscopic management of adnexal masses are highlighted by these 3 case reports. A thorough knowledge about GCT is important. Complete and clean removal of an unknown adnexal mass is imperative.

Background: Juvenile granulosa cell tumors account for about 5% of all granulosa cell tumors and are diagnosed in nearly 80% of cases during the first two decades of life. Only 10% of granulosa cell tumors present during pregnancy. The incidence of ovarian malignancies during pregnancy varies from 0.05 to 0.07 per 1000 pregnancies., Case: A 31-year-old pregnant woman was admitted to our university hospital due to an adnexal mass, 9.5 cm in diameter, which was detected at 34 weeks of gestation. At 37 + 5 weeks of gestation, a cesarean section with right salpingo-oophorectomy and removal of the tumor was performed. Histopathological findings, including immunohistochemical study, led to the diagnosis of juvenile granulosa cell tumor (JGCT)., Conclusion: The histological features and the differential diagnosis of the JGCT are discussed. The optimal management of such adnexal masses during pregnancy is also discussed. A JGCT that is confined to the ovary appears to have an excellent prognosis and can be treated by unilateral salpingo-oophorectomy.

Juvenile granulosa cell tumor (JGCT) of the ovary, if diagnosed at an early stage, has a favorable prognosis. Recurrences are uncommon but typically occur within the first year. The patient presented here was treated with a left oophorectomy after initial presentation. Tumor recurrence in the left adnexa, diagnosed 48 months later, was treated with cytoreductive surgery followed by chemotherapy; she remains disease free 19 months after this recurrence. Late recurrences of JGCT can occur and continued close surveillance is recommended.

Background: Granulosa cell tumors constitute only 5% of ovarian neoplasms, and their coexistence with pregnancy is extremely rare. Juvenile granulosa cell tumor has a good prognosis if it is confined to the ovary, but this type behaves more aggressively than the adult type at advanced stages., Cases: We report on successful completion of two singleton pregnancies and deliveries of normal infants in two young women with juvenile granulosa cell tumor diagnosed and treated during pregnancy. This tumor has rarely been described in association with pregnancy. The presence of trisomy 12 as a single chromosomal abnormality was detected in these two tumors. Both tumors were localized strictly to the ovary, so conservative surgery was applied and proved sufficient to remove all tumor tissue. Follow-up showed no signs of recurrence 18 and 53 months after the interventions., Conclusion: These cases support the contention that trisomy 12 is a nonrandom chromosome abnormality in juvenile granulosa cell tumors and that pregnancy may affect nuclear stability in this tumor.

The granulosa cell tumor is the most common sex ovary stromal tumors. Ten percent of cases present during pregnancy. Two histopathologically well defined patterns of granulosa cell tumors are known: the common adult granulosa cell tumors (AGCT) and the less frequent juvenile granulosa cell tumor (JGCT). This report describes a case of juvenile tumor of the granulosa occurring in a 22 year-old pregnant woman.

A case of juvenile tumour of the granulosa occurred in a pregnant woman. Outcome was rapidly fatal. These tumours are classed as mesenchyma tumours of the sexual cords of the ovaries. The juvenile form occurs before the age of 30 years in 97% of the cases and has characteristic endocrine and anatomic features. The tumour remains localized in the ovary for a long period and may be treated with conservative surgery to preserve fertility in these young patients. Follow-up is aimed at detecting relapse which may occur early. Prognosis in such cases is very poor. Pregnancy does not modify the prognosis which is generally good.

A granulosa-theca cell tumor was found in an ovary that had an ovulation fossa and normal ovarian tissue. The ovary was removed from a mare with a history of ovarian enlargement and behavioral changes. The affected ovary had a multicystic appearance on ultrasonographic examination performed before surgery, and an ovulation fossa was not palpable on examination per rectum. However, during surgery, the affected ovary was found to be within normal size limits, with an enlargement on 1 pole, and to contain an ovulation fossa. Atrophy of the infundibulum of the affected ovary helped to confirm the diagnosis of granulosa-theca cell tumor, and the ovary was removed. The mare's testosterone concentrations were normal. Granulosa-theca cell tumors are usually associated with a spherical ovary, attributable to ablation of the ovulation fossa, with no normal ovarian tissue present.

Sex cord-stromal tumors comprise approximately 5% of ovarian neoplasms and among these the granulosa cell tumor is the one most commonly seen (1). Two histopathologically well defined patterns of granulosa cell tumor are known: the common adult granulosa cell tumor (AGCT), and the less frequent juvenile granulosa cell tumor (JGCT) (1, 2, 3, 4). In addition to morphological variation, the two tumor types differ in prognosis and clinical course (4, 5, 6, 7, 8).

Seventeen granulosa cell, thirteen Sertoli-Leydig cell and six unclassified sex cord-stromal tumors diagnosed during pregnancy or the puerperium were reviewed. Eleven patients presented with abdominal pain or swelling, five in shock, two with virilization, and one with vaginal bleeding. Three asymptomatic patients were explored because of a palpable mass and one because of an adnexal mass found on ultrasound examination. In thirteen patients the tumor was discovered during a cesarean section; five of them had had dystocia and in eight of them the tumor was an incidental finding. All the tumors were Stage I but 13 of them had ruptured; all but one were unilateral. Hemoperitoneum was present in seven cases. On microscopical examination many of the tumors differed from tumors in the same diagnostic categories occurring in the absence of pregnancy by having a disorderly arrangement of their cells, lacking recognizable differentiation in many areas, showing prominent edema, and containing unusually large numbers of lutein or Leydig cells. The last two features were most obtrusive in tumors removed at term. With one exception the patients were initially treated by conservative surgical procedures. Two of them received chemotherapy and two radiation therapy postoperatively. A hysterectomy and salpingo-oophorectomy was performed at a second operation in eight cases; no residual tumor was found in any of the specimens. Only one patient had a recurrence, which was treated surgically. Follow-up for an average of 4.7 years is available for 30 of the 36 patients; all of them were alive and free of disease at the time of the last examination.