A rare case of ovarian granulosa cell tumour in an adolescent girl with secondary amenorrhea and virilisation

Abstract

Sex cord stromal ovarian tumors account for about 5-8% of all ovarian malignancies. Granulosa cell tumor is an   estrogen secreting low grade malignant tumor and is seen in women of all ages with 2% bilaterality. Based upon histology, these neoplasms can be classified as adult and juvenile Granulosa cell tumors. Pre-pubertal lesions present clinically with sexual pseudo precocity whereas post-pubertal lesions present with menstrual irregularities or secondary amenorrhea or postmenopausal bleeding. This case report presents a rare case of Granulosa cell tumor with clinical presentation mimicking virilizing ovarian neoplasm in a 19 year old girl with history of abdominal swelling, secondary amenorrhea and virilization since one year duration. Clinical examination revealed a 20-22 weeks size abdominal mass, cystic in consistency, arising from pelvis and CT scan suggested presence of mucinous cystadenoma with solid areas with suspected malignancy. Exploratory laparotomy with right salpingo-oophorectomy was performed with staging as tumor was found confined to ovary with no involvement of other ovary or any other pelvic organ or peritoneum. Therefore, disease was staged as stage 1A. Histopathological examination confirmed the presence of Granulosa cell tumor with fibrothecomatous areas.