Granulosa cell tumor

Chronic oral exposure of rats and mice to MDA and its dihydrochloride is carcinogenic. Treatment-related increases in the incidences of thyroid follicular cell adenomas and hepatocellular neoplasms were observed in mice after chronic ingestion of MDA in drinking water. In rats, increases in the incidences of thyroid follicular cell carcinoma and hepatic nodules were observed in males and thyroid follicular cell ademonas occurred in females. Although not statistically significant, certain uncommon tumors such as bile duct adenomas, papillomas of the urinary bladder, and granulosa cell tumors of the ovary also were reported. These tumors are of low incidence in historical controls. In another report, MDA acted as a promoter of thyroid tumors in rats. °... 

Groisman GM, Dische MR, Fine EM, Unger PD. Juvenile granulosa cell tumor of the testis a comparative immunohis-tochemical study with normal infantile gonads. Pediatr Pathol. 1993 13 389. 

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... 

TABLE 18.9 Differential Diagnosis of Granulosa Cell Tumor ... 

The second type of granulosa cell tumor that occurs in the ovary is the juvenile granulosa cell tumor.It occurs mainly in children and young women, but it can occur at any age, including in postmenopausal women. 

The tumor cells stain for inhibin and calretinin, " " " " and they usually show strong membrane staining for CD99 (Fig. 18.36).348 SF-1, WTl, and CD56 also are usually positive." Staining for cytokeratin is present in some tumors. Immunohistochemistry can help differentiate juvenile granulosa cell tumor from small cell carcinoma of the hypercalcemic type (see Table 18.9). 

Juvenile granulosa cell tumor is inhibin-positive, while small cell carcinoma does not stain for inhibin. 

FIGURE 18.36 juvenile granulosa cell tumor. Strong membrane staining for CD99 is present in nearly all juvenile granulosa cell tumors. 

Hildebrandt RH, Rouse RV, Longacre TA. Value of inhibin in the identification of granulosa cell tumors of the ovary. Hum Pathol. 1997 28 1387-1395. 

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. 

Fox H. Pathologic prognostic factors in early stage adult-type granulosa cell tumors of the ovary. Int J Gynecol Cancer. 2003 13 1-4. 

Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin Oncol. 2003 21 1180-1189. 

Hines JF, Khalifa MA, Moore JL, et al. Recurrent granulosa cell tumor of the ovary 37 years after initial diagnosis A case report and review of the literature. Gynecol Oncol. 1996 60 484-488. 

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. 

Otis CN, Powell JL, Barbuto D, et al. Intermediate filamentous proteins in adult granulosa cell tumors An immunohistochemical study of 25 cases. Am J Surg Pathol. 1992 16 962-968. 

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. 

Young RH, Dickersin GR, Scully RE. Juvenile granulosa cell tumor of the ovaty. A clinicopathological analysis of 125 cases. Am J Surg Pathol. 1984 8 575-596. 

SlOO Melanomas, schwannoma, neuroendocrine tumors Malignant peripheral nerve sheath tumors, chondrosarcoma and chondroblastoma clear cell sarcomas, myoepithelial tumors, granulosa cell tumor Neural crest cells (glial cells, Schwann cells, melanocytes and nevus cells), chondrocytes, adipocytes, myoepithelial cells, macrophages, adrenal medulla and paraganglia, Langerhans cells, dendritic cells... 

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... 

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