scholarly journals Adult Testicular Granulosa Cell Tumor: A Review of the Literature for Clinicopathologic Predictors of Malignancy

2011 ◽  
Vol 135 (1) ◽  
pp. 143-146 ◽  
Author(s):  
Joshua Anspach Hanson ◽  
Abiy B. Ambaye

Abstract Adult testicular granulosa cell tumors are rare sex cord–stromal tumors of which only 28 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. To date, there are no clinical or pathologic features that definitively predict malignancy. We reviewed all prior case reports for features that may predict their malignant potential. Tumor size greater than 5.0 cm is the only feature statistically associated with malignancy. Mitotic count, tumor necrosis, patient age, and the presence of gynecomastia do not, at present, predict benign versus malignant behavior.

2020 ◽  
pp. 106689692095362
Author(s):  
Ruby J. Chang ◽  
Jacquelyn Reuther ◽  
Ilavarasi Gandhi ◽  
Angshumoy Roy ◽  
Shilpa Jain ◽  
...  

Adult granulosa cell tumor (AGCT) and sex cord tumor with annular tubules (SCTAT) are distinct sex cord stromal tumors with different molecular signatures. We present a unique case of an incidental ovarian tumor with mixed AGCT and SCTAT morphologic patterns. Due to the unusual co-occurrence, molecular testing was separately performed on both components. Despite minimal overlap in morphology, both the SCTAT and AGCT components were found to have an identical mutation profile, including the prototypical FOXL2 p.C134W mutation characteristic of AGCT. We thus present the first report of AGCT with SCTAT-like pattern.


Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 117-119 ◽  
Author(s):  
Zhao Song ◽  
David J. Vaughn ◽  
Zhanyong Bing

Granulosa cell tumors can be classified into juvenile and adult types and more commonly occur in ovaries. Adult testicular granulosa cell tumors are extremely rare and only 29 cases of adult type have previously been reported. We report here a 28-year old Caucasian man with a left testicular adult type granulosa cell tumor. The tumor measured 2.6×2.6×2.5 cm and was mitotically active (10/10 HPF). Immunohistochemical stains showed the tumor diffusely positive for inhibin and vimentin, and negative for epithelial membrane antigen, cytokeratins, synaptophysin, HMB-45, OCT-4, placental-like alkaline phosphatase and lymphoid markers. The reported granulosa cell tumors in adult testis were briefly reviewed.


2018 ◽  
Vol 142 (12) ◽  
pp. 1459-1484 ◽  
Author(s):  
Robert H. Young

Context.— This year being the 60th anniversary of the publication of the excellent book Endocrine Pathology of the Ovary by John McLean Morris, MD, and Robert E. Scully, MD, the writer reflects on that work and in particular the remarkable contributions of its second author to our knowledge in this area. Objective.— To review ovarian sex cord–stromal tumors. Data Sources.— Literature and personal experience. Conclusions.— The essay begins with remarks on the oftentimes straightforward stromal tumors of the ovary because the commonest of them, the fibroma, dominates from the viewpoint of case numbers. Then, the sclerosing stromal tumor and the peculiar so-called luteinized thecomas of the type associated with sclerosing peritonitis are discussed in greater detail and their wide spectrum is illustrated. Brief mention is made of 2 rare neoplasms: the ovarian myxoma and signet-ring stromal tumor. Discussion then turns to the more recently recognized intriguing tumor tentatively designated microcystic stromal tumor and the commonest malignant tumor in this entire family, the so-called adult granulosa cell tumor, which despite its name may occasionally be seen in young individuals. The second variant of granulosa cell tumor—that which usually, but not always, occurs in the young—the so-called juvenile granulosa cell tumor, is then discussed. In the section of Sertoli-Leydig cell tumors, particular attention is focused on unusual tumors with heterologous elements and the remarkable so-called retiform tumors, which have a predilection for the young, often have distinctive gross features, and exhibit slitlike spaces and papillae. The essay concludes with consideration of the sex cord tumor with annular tubules.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Anand Mohapatra ◽  
Aaron M. Potretzke ◽  
Brent A. Knight ◽  
Min Han ◽  
Robert S. Figenshau

Granulosa cell tumors (GCTs) of the testis are rare sex cord-stromal tumors that are present in both juvenile and adult subtypes. While most adult GCTs are benign, those that present with distant metastases manifest a grave prognosis. Treatments for aggressive GCTs are not well established. Options that have been employed in previous cases include retroperitoneal lymph node dissection (RPLND), radiation, chemotherapy, or a combination thereof. We describe the case of a 57-year-old man who presented with a painless left testicular mass and painful gynecomastia. Serum tumor markers (alpha fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase) and computed tomography of the chest and abdomen were negative. The patient underwent left radical orchiectomy. Immunohistochemical staining was consistent with a testicular GCT. He underwent a left-template laparoscopic RPLND which revealed 2/19 positive lymph nodes. Final pathological stage was IIA. He remains free of disease 32 months after surgery.


1970 ◽  
Vol 39 (136) ◽  
pp. 351-353
Author(s):  
Kaveeta Dawaka ◽  
A Gupta ◽  
S Joshi ◽  
S Bajpai ◽  
H S Basi

A twenty eight year old lady, married for two years with no issue, presented at WesternRegional Hospital Pokhara on 8th July, 1999 with a history of amenorrhea for 1½years, lump abdomen 1 year, hoarseness of voice for 1 year and signs of hirsutism forthe same duration. She was taken up for laparotomy wherein a left ovariectomy withsalpingectomy was done and a large cystic ovarian tumor was removed. Post operativeperiod was uneventful and she was advised follow up. The histopathological diagnosiswas Adult Granulosa Cell Tumor. What made this case interesting is that mostGranulosa Cell Tumors (about 3/4th) are estrogenic or feminizing, but rare examples,including a disproportionate number of large thin walled cystic tumors are androgenic.This was one of those rare virilizing tumors with classical features of infertility,amenorrhea, hoarseness of voice, clitiromegaly, and breast atrophy, but we could notestimate testosterone levels due to lack of facilities available.Key Words: Granulosa Cell Tumor, Virilizing Ovarian Tumors, Sex Cord stromal tumors.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Azin Ashnagar ◽  
Samin Alavi ◽  
Yalda Nilipour ◽  
Roxana Azma ◽  
Farahnaz Falahati

Ovarian neoplasms are relatively rare in childhood and adolescence; only 5% to 8% of the cases are of sex cord stromal origin. Granulosa cell tumors are a group of estrogen producing sex cord stromal tumors of the ovary. They occur in 95% of the cases in adults, and only about 5% of the cases, which differ in histologic characteristics, are of juvenile type. A 13-year-old girl is reported who presented with massive abdominal distention and ascites. An abdominopelvic computed tomography scan showed a predominantly cystic mass lesion with septations arising from the left ovary. All tumor markers were normal, but serum inhibin level was increased. The patient underwent mass resection with salpingoophorectomy. Histopathology was compatible with the juvenile granulosa cell tumor. Interestingly, menarche was started in the patient soon after the surgery. To the best of our knowledge, massive ascites as the only clinical manifestation in the juvenile granulosa cell tumor has not reported as yet.


2016 ◽  
Author(s):  
Varkha Chandra ◽  
Sandhya Jain ◽  
Neerja Goel ◽  
Bindia Gupta ◽  
Shalini Rajaram

Introduction: Granulosa cell tumors comprise approximately 5% of all ovarian malignancy and account for 70% of malignant sex cord stromal tumors. Granulosa cell tumors have been diagnosed from infancy, the peak incidence being perimenopausal age. The potential of malignancy of these tumors is low, recurrences are often late and found in 10-33% of cases. Case Report: A 32-year-old P1L1 presented with large abdominal mass for which she underwent staging laparotomy with debulking surgery. She was a known case of granulosa cell tumor in the past and had undergone three laparotomies, along with chemotherapy. At the age of 13 yrs, she was diagnosed with a stage IA granulosa cell tumor (GCT) of the ovary first time. She underwent surgical staging and removal of left sided adnexal mass, after which she was asymptomatic for 7 years. In 2003 she again presented with lump abdomen for which she underwent resection of adnexal mass, histopathology was consistent with recurrent GCT. After second surgery she also received two cycles of chemotherapy. Despite adjuvant chemotherapy, patient presented again after three years in 2006 with adnexal mass and was found to have a third recurrence. At that time, she received 6 cycles of chemotherapy and the mass regressed. Meanwhile she got married and had one child. After four year in 2010 she again presented with lump abdomen and she underwent surgical staging, total abdominal hysterectomy with right salphingo ophorectomy along with removal of mass. After five year in 2015 she again presented with lump abdomen; there was a large pelvic mass which was removed and patient referred for chemotherapy. Discussion: GCTS which a rare malignant tumors of ovary tend to be associated with late recurrences. Although most recurrences occurs within 10 years after initial diagnosis, there are occasional reports of recurrences after10 years. We experienced the rare case of a patient who relapsed multiple times over 20 years, despite surgical and targeted treatment. Conclusion: The long history of granulosa cell tumor highlights the importance of extended follow up of the patient.


2021 ◽  
Vol 11 ◽  
Author(s):  
Hongbin Chi ◽  
Ning Huang ◽  
Huamao Liang ◽  
Rong Li ◽  
Congrong Liu ◽  
...  

We report a rare subtype of adult cystic granulosa cell tumor (AGCT) characterized by elevated anti-Mullerian hormone and hyperandrogenism. A 35-year-old woman with primary infertility, hyperandrogenism, and irregular menses who was previously diagnosed with polycystic ovarian syndrome was diagnosed with AGCT based on histopathological examination and FOXL2 genetic test after laparoscopy. Due to fertility aspirations, she underwent controlled ovarian stimulation followed by embryo cryopreservation before salpingo-oophorectomy, and two embryos were frozen-thawed and transferred after surgery. A healthy female infant was delivered at 40 weeks’ gestation. Cystic granulosa cell tumors should be considered a differential diagnosis in patients with persistent ovarian cysts and hyperandrogenism. Younger patients with AGCT with fertility goals should consider active assisted reproduction measures to preserve fertility before treatment for AGCT.


2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Klaus-Peter Dieckmann ◽  
Julia Bertolini ◽  
Christian Wülfing

Adult granulosa cell tumor (AGCT) of the testis represents a very rare testicular neoplasm that is poorly understood clinically. Here we report the case of a 22-year-old male who presented with unspecific scrotal symptoms. Scrotal sonography disclosed a 6 mm hypoechoic intratesticular lesion. Histological examination after orchiectomy revealed a homogeneous and well demarcated neoplasm with monomorphic cells with nuclear grooving and microfollicular formation of the so-called Call-Exner bodies. Immunohistology showed positive stainings of vimentin, calretinin, and inhibin with negative stainings of the typical germ cell tumor markers. Thus, the diagnosis of a benign AGCT was made. The patient is well one year after surgery. A total of 91 previous AGCT cases were identified in the literature. Median age of the cases reported to date is 44 years, median tumor size 3.2 cm. 54.3% of the AGCT cases were located on the left side. 12 cases (13.2%) were of malignant nature. Testis-sparing surgery would be the treatment of choice, but only two of all cases had received that procedure. The present report aims to increase the clinical knowledge of AGCT and specifically to increase the clinician’s vigilance with respect to testis-sparing surgery in probably benign testicular masses.


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