Cystic granulosa cell tumor of the ovary- diagnosed on histopathology: case report

Granulosa cell tumor (GCT) is an uncommon malignant neoplasm primarily arises from the sex-cord stromal cells of the ovary. They represent about 5 to 8 % of all cancers of the ovary. They belong to the category of sex-cord stromal tumors: juvenile or adult types are frequently used in the literature. Juvenile GCT represents only 5% of this tumor and usually occurs in pre-pubertal girls and women younger than 30 years whereas adult GCTs present with early stage disease and are commonly encountered in the age group of 35 years to 55 years. Granulosa cell tumors usually produce estrogens, and leads to symptoms and signs of estrogen excess. Endometrial hyperplasia and adenocarcinoma of uterus reported in 50 % and 15% of the cases of GCT respectively in peri-menopausal and postmenopausal women. However, virilizing granulosa cell tumors which produce androgens leading to virilization occur in pre-pubertal girls. Granulosa cell tumor (GCT) is characterized by a relatively low malignant potential, slow growth, less aggressive and late recurrence; however prognosis is influenced my many factors, such as age and stage at presentation, tumor size, necrosis, mitotic activity and histological staging. The treatment modalities include surgical excision, chemotherapy and radiotherapy which depend on tumor stage or combined regimen. However, irrespective of age and type of surgery, patients of GCT require regular follow-up.