A Case Report of Anaplastic Variant Juvenile Granulosa Cell Tumour

Document Type : Case report

Authors

1 Assistant Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor, Department of RadioOncology, Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Professor, Department of General Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Resident, Department of Surgical and Clinical Pathology, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Anaplastic variant of juvenile granulosa cell tumor is one of the rarest ovarian malignancies. The aim of this study is to describe a case of anaplastic variant ovarian granulosa cell tumor in a 14-year-old girl with presentation of abnormal uterine bleeding and gradual abdominal enlargement.
Case presentation: The patient at the time of diagnosis with an inhibin A and B more than 500 Pg/ml and ovarian mass of about 30×20×15 cm underwent unilateral salpingo-oophorectomy and juvenile granulosa cell tumor was diagnosed with no follow-up. She has referred with ascites, recurrent mass and distance metastasis of liver after 10 months. The patient underwent four courses of BEP (Bleomycin, Etoposide, Cisplatin)and five courses of paclitaxel and carboplatin. Then, she underwent laparotomy for metastasectomy, which was not successful due to the extent of involvement. Eventually, she died six months after the second surgery.
Conclusion: This case report confirms the need for accurate follow-up of patients with juvenile granulosa cell tumor and appropriate justification for the patient and their caregiver to prescribe needed adjuvant therapies to prevent recurrence.

Keywords


  1. Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. Journal of clinical oncology 2003; 21(6):1180-9.
  2. Rao AC, Kishore M, Monappa V. Juvenile Granulosa Cell Tumour: Anaplastic Variant with Omental Deposits. J Clin Diagn Res 2016; 10(2):ED01-3.
  3. Kalfa N, Philibert P, Patte C, Thibaud E, Pienkowski C, Ecochard A, et al. Tumeurs juvéniles de la granulosa: expression clinique et moléculaire [Juvenile granulosa-cell tumor: clinical and molecular expression]. Gynecol Obstet Fertil 2009; 37(1):33-44.
  4. Li J, Bao R, Peng S, Zhang C. The molecular mechanism of ovarian granulosa cell tumors. J Ovarian Res 2018; 11(1):13.
  5. Jamieson S, Fuller PJ. Management of granulosa cell tumour of the ovary. Current opinion in oncology 2008; 20(5):560-4.
  6. Young RH. Ovarian sex cord-stromal tumours and their mimics. Pathology 2018; 50(1):5-15.
  7. Clement PB, Young RH. Atlas of gynecologic surgical pathology. 4nd ed. Saunders; 2008.
  8. Smith R, Moss J, Shore I, El-Bahrawy MA. Juvenile granulosa cell tumour with hepatocyte-like cells and raised serum alpha-fetoprotein. Histopathology 2010; 57(4):637-41.
  9. Rusterholz KR, MacDonald W. An Unusual Case of Juvenile Granulosa Cell Tumor of the Ovary. Radiol Case Rep 2016; 4(1):178.
  10. McCluggage WG. Immunohistochemical and functional biomarkers of value in female genital tract lesions. Int J Gynecol Pathol 2006; 25(2):101-20.
  11. Roth LM. Recent advances in the pathology and classification of ovarian sex cord-stromal tumors. Int J Gynecol Pathol 2006; 25(3):199-215.