Primary retroperitoneal extraovarian granulosa cell tumor

Extraovarian granulosa cell tumors (GCTs) develop from ectopic gonadal tissue situated along the embryonal route of the genital ridge. Primary retroperitoneal tumors are extremely rare, with an incidence of 02% -06% and 80-85% probability of malignancy. Only eight such case reports have been published previously. We herein, report a rare case of extraovarian retroperitoneal GCT in a 55-year-old woman who presented with intermittent left lumbar region pain of one-year duration. She had a history of hysterectomy and bilateral salpingo-oophorectomy 8 years ago for uterine leiomyoma. Laparotomy revealed a retroperitoneal mass measuring 8cm x 10cm x 20cm in size, solid cystic with areas of necrosis and hemorrhage. The gross features, classical histopathology, and positive immunostaining of the retroperitoneal mass with inhibin, calretinin, PR, WT1 and immunonegativity for EMA were characteristic of adult-type GCT. Excluding any previous history of primary ovarian GCT in this patient, a de-novo retroperitoneal diagnosis was established.

Tumor de células de la granulosa de tipo juvenil en ovario izquierdo / Juvenile granulosa - cells tumor in the left ovary

RESUMEN Se presentó el caso de una adolescente de 14 años, en el servicio de Cirugía Pediátrica del Hospital Pediátrico Docente "Pedro Agustín Pérez" de Guantánamo, que refirió aumento de volumen de todo el abdomen y dolor abdominal difuso. Al examinarla se constató una tumoración visible y palpable en hemiabdomen inferior. Los estudios complementarios imagenológicos mostraron una masa ecogénica, heterogénea que ocupaba hipogastrio, más lateralizada hacia la izquierda. Tras discusión colectiva multidisciplinaria se le realizó oforectomía izquierda y los estudios anatomopatológicos confirmaron la presencia de tumor de células de la granulosa de tipo juvenil en ovario izquierdo. Técnicas quirúrgicas que permitan preservar la capacidad reproductiva a niñas con neoplasias malignas, resultan usadas ahora con frecuencia y garantizan una mayor calidad de vida.

ABSTRACT A 14-year-old girl presented to the pediatric surgery department at the Pediatric Teaching Hospital "Pedro Agustín Pérez" in Guantanamo. She reported a difuse abdominal pain and distention. The examination revealed a visible and palpable tumor in the lower hemiabdomen. Complementary imaging studies showed an ecogenic and heterogeneous mass situated in the left hypogastrium. After a multidisciplinary team meeting, an ophthalmectomy was performed, and anatomopathological studies confirmed the presence of juvenile granulosa cells tumor on the left ovary. Surgical techniques that allow girls with malignant neoplasms to preserve their reproductive capacity are now frequently used and they guarantee higher life quality.

Ovarian Gynandroblastoma with a Juvenile Granulosa Cell Tumor Component in a Postmenopausal Woman: A Case Report and Literature Review

Gynandroblastoma is an extremely rare sex cord-stromal tumor with both female (granulosa cell tumor) and male (Sertoli-Leydig cell tumor) elements. Juvenile granulosa cell tumors are also very rare and are so named because they usually occur in children and adolescents. A 71-year-old woman with right upper quadrant abdominal pain visited our hospital. Pelvic computed tomography showed a large multilocular cystic mass, suspected to be of ovarian origin. We performed a total abdominal hysterectomy (total abdominal hysterectomy was performed) with bilateral salpingo-oophorectomy. A 13-cm multilocular cystic mass with serous fluid was observed in her right ovary. Upon microscopic examination, the solid component of the mass showed both Sertoli-Leydig cell and juvenile granulosa cell differentiation, which we diagnosed as gynandroblastoma. Gynandroblastoma with a juvenile granulosa cell tumor component is extremely rare and, until now, only six cases have been reported in the English literature. We report the first gynandroblastoma with a juvenile granulosa cell tumor component diagnosed in an elderly patient, along with a literature review.

Tumor de las células de granulosa: pubertad precoz en lactante menor de 1 año. Caso clínico / Granulosa cell ovarian tumor: precocious puberty in infant less than 1 year of age. Case report

Resumen Introducción: Los tumores de las células de la granulosa de tipo juvenil (TCGJ) son muy poco fre cuentes, especialmente en menores de 1 año. Los signos de pubertad precoz constituyen la presenta ción clínica más importante. Objetivo: Presentar una lactante con pubertad precoz periférica, con diagnóstico de TCGJ, discutiendo las claves de su tratamiento y seguimiento. Caso Clínico: Lactante de 10 meses que presentó telarquia, vello púbico y tumor abdominal palpable acompañado de niveles plasmáticos de Estradiol aumentados, gonadotrofinas muy bajas e imágenes que mostraban masa ovárica gigante. Se realizó salpingooforectomía, obteniéndose regresión absoluta de signos y síntomas. La biopsia demostró TCGJ por lo que se tomó inhibina B (InB) como marcador después de la cirugía. Esta hormona estaba alta inicialmente, pero descendió rápidamente. El seguimiento se basó en InB, Hormona antimulleriana (AMH) y estradiol como se describe en este tipo de tumores. Conclusiones: Los TCGJ son muy infrecuentes en pediatría; deben sospecharse en niñas con puber tad precoz periférica. El tratamiento quirúrgico en la gran mayoría es curativo, pero debe mantenerse un estricto control con marcadores tumorales, siendo los más específicos la InB y la AMH y en menor escala los niveles de Estradiol.

Abstract Introduction: Juvenile granulosa cell tumors (JGCT) are very rare, especially in infants under the age of one. The most frequent presentation is with signs of precocious puberty. Objective: Present an in fant with peripheral precocious puberty, diagnosis of JGCT and follow up. Clinical case: 10-month-old female infant with thelarche, pubic hair and palpable abdominal mass accompanied with eleva ted levels of estradiol, very low gonadotrophins and images that show a very large ovarian mass. A sapingooforectomy was carried out with full regression of symptoms and signs and improvement of laboratory exams. The biopsy showed TCGJ so inhibin B (InB) was taken as tumoral marker after surgery. This hormone was high initially, but rapidly declined. Follow-up was based on InB, antimu-llerian Hormone (AMH) and estradiol as described in this type of tumors. Conclusions: Juvenil gra nulosa cell tumors are very infrequent in pediatric age, but should be suspected in girl with peripheral precocious puberty. The majority of cases improve with surgery, but strict surveillance of tumoral markers is needed. The most specific markers are inhibin B and anti mullerian hormone (AMH), followed by estradiol levels.

Tumor de células de la granulosa: neoplasia estromal de los cordones sexuales: revisión de la literatura, a propósito de dos casos clínicos / Granulosa cell tumor: stromal neoplasm of the sexual cords: review of the literature and clinical cases

Los tumores de las células de la granulosa, hacen referencia a un conjunto de neoplasias derivadas del tejido estromal de los cordones sexuales, secretores de estrógenos, que corresponden al 1-5% de todos los tumores malignos del ovario, aunque pueden presentar localizaciones extraováricas. Son tumores raros e infrecuentes, cuya incidencia general varía de 0,4 a 1,7 casos por cada 100.000 mujeres al año. Se clasifican en dos grupos diferenciados en función de la edad de las pacientes, su historia natural y sus características patogénicas: tumores de células de la granulosa tipo adulto (TCGA) o tipo juvenil (TCGJ). El diagnóstico de esta rara patología se basa en cuatro pilares fundamentales, por un lado, las manifestaciones clínicas y la confirmación mediante pruebas de imagen, y, por otro lado, los marcadores tumorales y el estudio inmunohistoquímico de las muestras biológicas. En el manejo terapéutico de los estadios iniciales de la enfermedad (supervivencia a los 5 años superior al 90% en los estadios I), se recomienda el tratamiento quirúrgico mediante histerectomía con anexectomía bilateral en pacientes con TCGA y deseos genésicos cumplidos, reservando la anexectomía unilateral para los casos de TCGJ o para aquellas pacientes sin descendencia (aunque con posterioridad se recomienda completar el tratamiento). La quimioterapia sistémica postoperatoria se incluye cuando existe extensión extraovárica o recurrencia de la enfermedad. La tasa de recidiva (considerado uno de los principales factores de mal pronóstico), es alta en estadios avanzados, aunque la probabilidad de desarrollar metástasis a distancia es baja.

Tumors of the granulosa cells refer to a set of neoplasms derived from the stromal tissue of the sex cords, secretory of estrogens. They correspond to 1-5% of all malignancies of the ovary, though they may have extraovarian locations. These tumors are rare and uncommon, whose general incidence may vary from 0.4 to 1.7 cases per 100,000 women per year. They are classified into two groups depending on the age of the patients, their natural history and their pathogenic characteristics: adult type tumors of the granulosa cell (AGCT) or juvenile type (JGCT). The diagnosis of this rare pathology is based on the study of clinical manifestations and confirmation through image tests, and also on tumor markers tests and the immunohistochemical study of biological samples. In the therapeutic handling of the early stages of the disease (5-year survival greater than 90% in stage I), surgical treatment via hysterectomy with bilateral adnexectomy in patients with AGCT and met genesic perspectives is recommended; for the cases of JGCT or for those patients without progeny, preserving the unilateral adnexectomy is justified (although completion of the treatment is recommended at later stages). Postoperative systemic chemotherapy is practiced when there is extraovarian extension or recurrence of the disease. The rate of relapse (considered one of the main factors of poor prognosis), is high in advanced stages, although the probability of developing distant metastasis is low.

Tumor da célula da granulosa associado à piometra em uma gata de sete meses / Granulosa-cell tumor associated with pyometra in a seven months old cat

As neoplasias ovarianas em gatas são raras e, quando relatadas, estão associadas a animais senis, assim como a piometra de causa não iatrogênica. O objetivo deste trabalho foi relatar o caso de uma gata jovem com neoplasia ovariana, tumor de células da granulosa associado ao complexo hiperplasia endometrial cística/piometra (HECP). O animal foi atendido no setor de Reprodução Animal e Obstetrícia Veterinária (RAOV) de um Hospital Veterinário Escola, com histórico de monta natural recente, anorexia, êmese, polidipsia, poliúria e descarga vaginal purulenta. Ao exame físico, observou-se apatia, mucosas ictéricas, aumento de volume da região abdominal e presença de secreção vaginal purulenta. À ultrassonografia, foi visibilizado conteúdo ecogênico no útero diagnóstico de HECP e estrutura ecogênica na cavidade abdominal, na região ovariana, confirmado pelo exame histopatológico como sendo tumor das células da granulosa. A conduta terapêutica adotada foi a cirurgia de ovariossalpingo-histerectomia (OSH).(AU)

Ovarian neoplasias in cats are rare, and are associated with advanced ages, as well as non-iatrogenic pyometra. The objective of the present study was to report a case of a young cat showing signs of a rare neoplasia, the granulosa-cell tumor, associated with complex cystic endometrial hyperplasia/pyometra (HECP). The animal was attended in the Animal Reproduction and Veterinary Obstetrics sector of a Teaching Veterinary Hospital with a history of natural breeding, anorexia, emesis, polydipsia, polyuria, and purulent vaginal discharge. During clinical examination, apathy, icterus, swelling of the abdomen, and purulent vaginal discharge were observed. On the ultrasonographic exam, an echogenic content inside the uterus was observed, leading to diagnosis of HECP and an echogenic structure in the abdominal cavity, in ovarian region, confirmed by histopathology as being of granulosa cells. The therapeutic conduct adopted was salpingo-oophorectomy and hysterectomy surgery (OSH).(AU)

Tumor de células granulares de la vulva: caso clínico / Granular cell tumor of the vulva: a clinical case

El tumor de células granulares es una neoplasia de la piel y los tejidos blandos muy poco frecuente, benigna y de crecimiento lento, pero con altas tasa de recurrencia. La localización más frecuente en el aparato genital es en la vulva. Se debe realizar diagnóstico diferencial con otras lesiones vulvares, debido al manejo distinto de esta tumoración. El diagnóstico generalmente es histológico, ya que clínicamente es muy difícil diferenciarlo de otras tumoraciones a nivel vulvar. El tratamiento recomendado es la exéresis quirúrgica, con márgenes de seguridad. En caso de bordes afectos, se recomienda realizar una reescisión, por la frecuencia de recurrencia local y porque ésta puede ser el primer indicador de una conducta agresiva. Presentamos un caso clínico a nivel vulvar, con el objetivo de destacar la importancia de realizar un diagnóstico correcto, para un buen manejo clínico y seguimiento. Las formas malignas suponen menos del 3% de estos tumores y son muy agresivas

The granular cell tumor is a neoplasm of the skin and soft tissue very rare, benign and slow growing, but with high recurrence rate. The most frequent location in the genital tract is in the vulva. Differential diagnosis should be made with other vulvar lesions, due to differences in the management of this tumor. The diagnosis is usually histological, since it is clinically difficult to differentiate it from other tumors at the vulvar level. The recommended treatment is surgical excision, with safety margins. In case of affected borders, it is recommended to perform a resection, due to the local recurrence and this may be the first indicator of aggressive behavior. We present a clinical case at the vulvar level, in order to emphasize the importance of making a correct diagnosis, for a good clinical management and follow-up. Malignant forms account for less than 3% of these tumors and are very aggressive.

Tumores malignos sincrónicos de ovario y endometrio / Ovary malignant synchronous tumors and endometrium

Los tumores malignos sincrónicos primarios de ovario y endometrio son raros y se reportan en alrededor de un 5 por ciento y pueden tener muy buen pronóstico cuando son detectados tempranamente. El objetivo del presente trabajo es dar a conocer a la comunidad científica el caso de un paciente con tumores malignos concurrentes de ovario y endometrio poco frecuentes. Se presenta una paciente femenina de 67 años de edad, multípara, de color de piel blanca, a la cual se le diagnosticó un adenocarcinoma de endometrio y en el curso de la cirugía se encontró un tumor sólido de ovario y el diagnóstico histopatológico arrojó un tumor de las células de la granulosa. Los tumores sincrónicos de ovario y endometrio parecen tener mejor pronóstico y sobrevida cuando son de bajo grado y diagnosticados en etapas tempranas(AU)

The primary synchronous malignant ovarian and endometrial tumors are rare and they are reported in around 5 percent. They can have very good prognosis when they are early detected. The aim of this paper is to inform the scientific community the case of a patient with concurrent malignant tumors of ovarian and endometrial infrequent. We present a 67 year old female patient, multiparous, white skin color, who was diagnosed with an endometrial adenocarcinoma. In the course of surgery, a solid ovarian tumor was found. Her histopathologic diagnosis yielded a granulose-cell tumor. Synchronous ovarian and endometrial tumors appear to have a better prognosis and survival when they are low grade and diagnosed at early stages(AU)

Histopathologic findings in uteri and ovaries collected from clinically healthy dogs at elective ovariohysterectomy: a cross-sectional study

Opinions on ovariohysterectomy (OHE) of bitches vary depending on region and country. In this descriptive, prospective cross-sectional study, uterine tracts and ovaries exhibiting gross pathologic findings (n = 76) were collected post-surgery from a reference population of 3,600 bitches (2.11% incidence) that underwent elective OHE during September to November 2013 and evaluated by histopathology examination. Data were evaluated by using descriptive statistics and chi-squared tests. Bitches were of crossbred background with average age 5 years (range 0.6–8.0 years) and most were nulliparous (69.7%) with no anamnesis of reproductive diseases (81.6%). Frequencies of proestrus, estrus, and diestrus were 42.1%, 6.6%, and 19.7%, respectively. The presence of mammary gland masses (5.3%) significantly correlated with histopathologic findings in ovaries and age of the bitch (p < 0.05). Predominant uterine histopathologies included cystic endometrial hyperplasia, periglandular fibrosis, lymphoplasmocytary endometritis, and adenomyosis (19.7%, 14.5%, 4.0%, and 2.6%, respectively). In ovaries, hyperplasia of rete ovarii, follicular cysts, oophoritis, adenoma of the rete ovarii, cysts of superficial structures, and granulosa cell tumors (10.5%, 10.5%, 7.9%, 4.0%, 2.6%, and 2.6%, respectively) were observed. The results reveal the presence of subclinical pathologies in healthy bitches, suggesting that OHE at an early age is beneficial for prevention of reproductive pathologies.

Adult granulosa cell tumors of the ovary: a retrospective study of 30 cases with respect to the expression of steroid synthesis enzymes / 부인종양

OBJECTIVE: Some, but not all, granulosa cell tumors are characterized by estrogen production. This study was designed to determine whether there are clinical or pathological variations in granulosa cell tumors in relation to the expression of sex steroid synthesis enzymes. METHODS: Clinical symptoms, serum hormonal values, and histology of 30 granulosa cell tumor patients who underwent surgery between 2002 and 2014 were retrospectively reviewed. RESULTS: Most patients presented with abnormal genital bleeding including abnormal menstrual cycles. Eight of 16 patients older than 50 years had endometrial hyperplasia and one had endometrial cancer. Serum 17β-estradiol (E2) levels tended to be higher in patients over 50 years of age (p=0.081). Serum follicle-stimulating hormone (FSH) levels were low in all patients irrespective of serum E2 levels. Magnetic resonance imaging revealed a thicker endometrium in older as compared to younger patients (p<0.05). Tumor cells in the majority of cases were positive for inhibin α and P450 aromatase, irrespective of age and serum E2 levels. P450 17α-hydroxylase (P450c17) expression varied among cases. P450c17 was strongly positive in luteinized tumor cells and weakly positive in theca cells and fibroblasts. High E2 levels were associated with P450c17-positive cells in the tumor (p<0.05). CONCLUSION: The expression of hormone-synthesizing enzymes divides granulosa cell tumors into 2 distinct types; tumors with P450c17-positive cells show elevated serum E2 and related clinical symptoms, while tumors without these cells show symptoms related to FSH suppression by inhibin.

Metástasis pulmonar de tumor de células de la granulosa como recurrencia del tumor primario después de diez años del tratamiento quirúrgico / Pulmonary metastasis of granulosa cell tumor as recurrence of primary tumor after 10 years of surgical treatment

Los tumores de células de la granulosa son neoplasias de bajo grado, que corresponden al 2-5% de los tumores malignos del ovario y presentan una baja incidencia. Las manifestaciones clínicas dependerán del tamaño tumoral y de la exposición prolongada a estrógenos producidos por las células neoplásicas. Habitualmente, son tumores unilaterales, sólido-quísticos con focos de hemorragia, constituidos por células pálidas con su característico pliegue nuclear, en un trasfondo fibrotecomatoso, con cuerpos de Call Exner sólo en el 30-60% de los casos. El diagnóstico se realiza con los niveles séricos de estradiol y con exámenes imagenológicos como ecotomografía ginecológica, tomografía axial computarizada o resonancia nuclear magnética. El tratamiento quirúrgico es la elección. Las recurrencias pueden ocurrir años posteriores al diagnóstico inicial y en general son pélvicas. El factor pronóstico más determinante en la evolución de la enfermedad es el estadio clínico al momento del diagnóstico. Se presenta el caso clínico de una paciente postmenopáusica con metástasis pulmonar de tumor de células de la granulosa después de diez años del tratamiento quirúrgico.

The granulosa cell tumors are low grade neoplasias that correspond to 2-5% of all malignant tumors of the ovary with a low incidence in the population. The clinical presentation depends on the tumor size and the long term exposition to estrogens produced by neoplastic cells. They are usually unilateral tumors exhibiting a mixture of cystic and solid areas with bleeding, constituted by pale cells with their characteristic nuclear groove in a fibrotecomatous background, with Call Exner bodies only in 30-60% of cases. The diagnosis is done with serum levels of estradiol and gynecological imaging analysis such as echotomography, Computerized axial tomography and magnetic nuclear resonance. The surgical treatment is the choice. The recurrences could happen years after the first diagnosis and usually are in pelvic area. The most important prognostic factor in the disease progression is the clinical stage at diagnosis. It is presented a case report of a postmenopausal patient with lung metastasis of granulosa cell tumor after ten years of surgical treatment.

Insights into granulosa cell tumors using spontaneous or genetically engineered mouse models / 대한생식의학회지

Granulosa cell tumors (GCTs) are rare sex cord-stromal tumors that have been studied for decades. However, their infrequency has delayed efforts to research their etiology. Recently, mutations in human GCTs have been discovered, which has led to further research aimed at determining the molecular mechanisms underlying the disease. Mouse models have been important tools for studying GCTs, and have provided means to develop and improve diagnostics and therapeutics. Thus far, several genetically modified mouse models, along with one spontaneous mouse model, have been reported. This review summarizes the phenotypes of these mouse models and their applicability in elucidating the mechanisms of granulosa cell tumor development.

Adult granulosa cell tumor of the testis masquerading as hydrocele

Adult testicular granulosa cell tumor is a rare, potentially malignant sex cord-stromal tumor, of which 30 cases have been described to date. We report the case of a 43-year-old male who complained of a left testicular swelling. Scrotal ultrasound showed a cystic lesion, suggestive of hydrocele. However, due to a clinical suspicion of a solid-cystic neoplasm, a high inguinal orchidectomy was performed, which, on pathological examination, was diagnosed as adult granulosa cell tumor. Adult testicular granulosa cell tumors have aggressive behaviour as compared to their ovarian counterparts. They may rarely be predominantly cystic and present as hydrocele. Lymph node and distant metastases have been reported in few cases. Role of MIB-1 labelling index in prognostication is not well defined. Therefore, their recognition and documentation of their behaviour is important from a diagnostic, prognostic and therapeutic point of view.

Diagnóstico prenatal de tumor de células de la granulosa de tipo juvenil / Prenatal diagnosis of juvenile granulosa cell tumor

Presentamos un caso clínico de diagnóstico prenatal de una masa testicular. Tras el nacimiento, se realizó la exéresis del tumor y el análisis anatomopatológico determinó que se trataba de un tumor de células de la granulosa juvenil. Los tumores testiculares son raros y deben considerarse en el diagnóstico diferencial de las masas escrotales en los neonatos. El tumor de células de la granulosa juvenil es una entidad clínico-patológica poco frecuente, que representa el 5% de los tumores testiculares prepuberales. Se considera una neoplasia benigna y la orquiectomía es una técnica quirúrgica curativa.

We report a case of a prenatally diagnosed testis tumor. After delivery, it was decided to perform right radical orchiectomy which was subsequently diagnosed as a juvenile granulosa cell tumor. Neonatal testicular tumors are rare and should be considered in the differential diagnosis of newborn scrotal masses. Juvenile granulosa cell tumor is a rare benign neoplasm of the testicular stroma that accounts for 5% of all prepuberal testis tumors. As a benign neoplasm, orchiectomy is sufficient for treatment.

Unicystic Granulosa Cell Tumor

No abstract available.

Adult granulosa cell tumor presenting with massive ascites, elevated CA-125 level, and low 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography

Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature. An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer. AGCT has low 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography due to its low metabolic activity. In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

Tumor de células de la granulosa asociado a hiperandrogenismo femenino rápidamente progresivo / Granulosa cell tumour associated with rapidly progressive female hyperandrogenism

Reportamos el caso de una mujer de 21 años con hiperandrogenismo rápidamente progresivo de origen tumoral ovárico. La biopsia informó tumor de células de la granulosa y la resección fue curativa. Se analizan los posibles mecanismos por los que un tumor de origen en células de la granulosa pueda sintetizar andrógenos.

We report a 21 year old woman with rapidly progressive hyperandrogenism of ovaric tumoral origin. The biopsy of the tumor reported a granulosa cell tumor and the surgery was curative. We analyze the possible mechanisms implied in the androgen production in the granulosa cells of the tumor.

Síndrome de desarrollo sexual precoz por tumor de células granulosas: presentación de un caso / Syndrome of precocious sexual development by granulomatous cell tumor: presentation of a case

Se describe un caso de tumor de ovario de células granulosa juvenil, cuya manifestación inicial fue una pubertad precoz isosexual, en una niña de tres años, de evolución progresiva y rápida, asociada a una masa hipogástrica palpable. La valoración hormonal demostró estradiol, elevado; 17aOH-progesterona, 13,44 ng/ml; la FSH inhibida, al igual que la LH, la alfa feto proteína normal. Exámenes de imagen confirmaron masa tumoral en ovario derecho. La exéresis del tumor de ovario derecho de aproximadamente 10-12 cm, sólido, bien delimitado de superficie granulosa, en conjunto con la trompa englobada en el proceso. El examen histopatológico demostró un tumor de células de la granulosa juvenil. La paciente ha evolucionado satisfactoriamente después del tratamiento quirúrgico, no presenta signos de metástasis. Las dosificaciones hormonales se encontraron dentro del rango de la normalidad.

We describe a case of juvenile ovarian tumor of granulose cells. Its initial manifestation was an isosexual precocious puberty, in a girl aged 3 years, of a rapid and progressive evolution, associated to a palpable hypogastric mass. The hormonal assessment showed estradiol, high; 17aOH-progesterona, 13,44ng/ml, inhibited FSH, the same as LH, normal alpha fetoprotein. The imaging examination confirmed a tumoral mass in the right ovary. We extirpated the right ovary tumor of nearly 10-12 cm, solid, well delimitated with a granulose surface, together with the tube involved in the process. The histopathologic examination showed a juvenile tumor of granulose cells. After the surgical treatment the patient has evolved satisfactorily, not showing symptoms of metastasis. The hormonal dosages were found in the normal range.