Ovarian tumors granulosa cell

Tumors derived from the sex cords or ovarian mesenchyme compose 5% to 12% of all ovarian neo-plasms. 413 Benign tumors in the fibroma-thecoma group are relatively common. Other sex cord-stromal tumors and mesenchymal tumors are rare. The most common malignant sex cord- stromal tumor is granulosa cell tumor, which composes 1% of 2% of all malignant ovarian tumors. There are two types of granulosa cell tumors an adult type that occurs mainly in postmenopausal... 

Ohishi Y, Kaku T, Oya M, et al. CD56 expression in ovarian granulosa cell tumors, and its diagnostic utility and pitfalls. Gynecol Oncol. 2007 107 30-38. 

Gitsch G, Kohlberger P, Steiner A, et al. Expression of cyto-keratins in granulosa cell tumors and ovarian carcinomas. Arch Gynecol Obstet. 1992 251 193-197. 

Farinola MA, Gown AM, Judson K, et al. Esttogen teceptor alpha and progesterone receptor expression in ovarian adult granulosa cell tumors and Sertoli-Leydig cell tumors. Int J Gynecol Pathol. 2007 26 375-382. 

Wilms tumor protein-1 (WT-1) Nephroblastoma, mesothelioma, metanephric adenoma, ovarian serous carcinoma AML, desmoplastic small round cell tumor, endometrial stromal sarcoma, uterine leiomyosarcoma, granulosa cell tumor, thecoma, rhabdoid tumor Kidney, mesothelial cells, granulosa cells, Sertoli cells, fallopian tube endometrial stroma, spleen... 

In a study of human ovarian tumors, McKay et al. (1949) found the quantity of histochemically reactive lipids to be directly related to the functional activity of these tumors. Moreover, in tumors with estrogenic activity the reactive lipids were confined to thecal cells, in either granulosa cell tumors or thecomas. In tumors with progestational activity, the lipids were in the lutein cells. Deane and Fawcett (1952), working with experimental tumors produced by transplanting ovaries to the spleens of... 

Fig. 9.12. Granulosa cell tumor. A 52-year-old female with a history of hysterectomy and unilateral oophorectomy for granulosa cell tumors several years before. A solid and cystic pelvic tumor with irregular margins displacing bowel loops is seen at the acetabular level. From imaging, it cannot be differentiated from an ovarian cancer...

Differential diagnosis includes solid ovarian tumors in younger age, e.g., granulosa cell tumors and teratomas. In MRI, uterine fibroma and fibrothecoma may display a similar appearance on T2-weighted images however, contrast enhancement in these tumors is less and delayed. Especially in CT, differentiation of subserosal uterine fibroids from solid dysgerminomas is not possible. 

Sex cord stromal tumors derive from coelomic epithelium or mesenchymal cells of the embryonic gonads [54], Eight percent of all ovarian neoplasms account for this tumor type, with granulosa cell tumors, fibrothecomas, and Sertoli-Leydig cell tumors comprising the majority of these tumors. In contrast... 

The adult granulosa cell tumors usually occur after the age of 30 years and have their peak incidence in the perimenopausal age [54]. Because of their estrogen activity, they can become clinically apparent with abnormal uterine bleeding and endometrial hyperplasia. Endometrial cancer is associated with these tumors in 5%-25% of cases [58]. Both types of granulosa cell tumors are typical unilateral ovarian tumors that vary considerably in size and show an average diameter of approximately 12 cm [54]. 

Fig. 10.28. Juvenile type of granulosa cell tumor. CT in a 17-year-old girl who presented with primary amenorrhea. A large, well-defined cystic ovarian tumor with multiple irregular septations and solid areas is demonstrated in the midpelvis. Small amounts of ascites (asterisk) without evidence of peritoneal seeding at surgery...

Either benign or malignant ovarian tumors may be associated with virilization. Virilization has been observed in patients with adrenal rest tumors, Leydig cell tumors, granulosa cell tumors, Brenner tumors, and arrhenoblastomas. In patients with hirsutism associated with amenorrhea and sterility, the androstene-... 

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