Clinicopathological study of 24 cases of ovarian cellular fibromas / 中国肿瘤临床

Objective:To investigate the clinical and pathological characteristics of ovarian cellular fibromas.Methods:The sample con-sisted of 24 cases of ovarian cellular fibromas from February 2008 to March 2017 in the Obstetrics and Gynecology Hospital of Fudan University.Clinical histories were retrieved,and pathological slides were reviewed.Results:The age of the patients ranged from 17 to 70 years old,with a mean age of 46.5 years.Clinical symptoms included ovarian masses,abdominal pain,or pleuroperitoneal fluid.Se-rum CA125 notably increased in two patients.Of the 24 cases,13 and 10 occurred in the right and left ovaries,respectively,and one case occurred bilaterally.Tumor cells were densely cellular in all cases and were mitotically active in three cases(5-7/10 high power fields).A minor component of sex cord elements(<10% area of the tumor)was present in three cases,and luteinized cells were ob-served in four cases.None of the cases manifested recurrence during follow-up ranging from 1 month to 109 months.Conclusion:Ovarian cellular fibromas are pure ovarian stromal tumors that may manifest mitotic activity, sex cord elements, and luteinization. Some patients present with pleuroperitoneal fluid and increased CA125.Thus,the pathological features of cellular fibromas must be mastered to avoid misdiagnosis for other benign or malignant tumors and improper treatment.

Clinicopathological study of 24 cases of ovarian cellular fibromas / 中国肿瘤临床

Objective:To investigate the clinical and pathological characteristics of ovarian cellular fibromas.Methods:The sample con-sisted of 24 cases of ovarian cellular fibromas from February 2008 to March 2017 in the Obstetrics and Gynecology Hospital of Fudan University.Clinical histories were retrieved,and pathological slides were reviewed.Results:The age of the patients ranged from 17 to 70 years old,with a mean age of 46.5 years.Clinical symptoms included ovarian masses,abdominal pain,or pleuroperitoneal fluid.Se-rum CA125 notably increased in two patients.Of the 24 cases,13 and 10 occurred in the right and left ovaries,respectively,and one case occurred bilaterally.Tumor cells were densely cellular in all cases and were mitotically active in three cases(5-7/10 high power fields).A minor component of sex cord elements(<10% area of the tumor)was present in three cases,and luteinized cells were ob-served in four cases.None of the cases manifested recurrence during follow-up ranging from 1 month to 109 months.Conclusion:Ovarian cellular fibromas are pure ovarian stromal tumors that may manifest mitotic activity, sex cord elements, and luteinization. Some patients present with pleuroperitoneal fluid and increased CA125.Thus,the pathological features of cellular fibromas must be mastered to avoid misdiagnosis for other benign or malignant tumors and improper 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 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.

Granulosa cell tumor of testis: Clinicopathological correlation of a rare tumor.

Background: Granulosa cell tumor of testis is a rare tumor accounting for less than 4% of adult testicular tumors though they account for nearly 30% of childhood testicular tumors. Due to the rarity of these tumors, exact etiology, pathogenesis, prognostic factors and best treatment approach are not well known. The molecular events in pathogenesis of these stromal tumors have begun to unravel and these developments put forth a reasonable and scientifi c explanation for the association of these tumors with developmental anomalies like undescended testis. However, many questions remain unanswered. Materials and Methods: We performed a retrospective analysis of clinicopathological features of all Granulosa Cell Tumors of testis from our archives in addition to an extensive literature search using PUBMED with the key words “Granulosa Cell Tumor, testis”. Results: We found six cases in our archives, two of which were of juvenile type and four of adult type. One out of these six cases presented with metastases. All cases underwent radical orchidectomy. Morphology and immunohistochemistry were classical in all cases and there was no diagnostic dilemma. Literature search revealed 63 cases of testicular Granulosa Cell Tumor in addition to highlighting the similarities in the biology and the dissimilarities in the clinical behavior as compared to ovarian Granulosa Cell Tumor. Conclusion: Testicular Granulosa Cell Tumor is a rare tumor, which although histologically similar to its ovarian counterpart, differs in clinical behavior. Further detailed investigations are needed to reveal the mystery behind the differing clinical behavior despite histological and immunohistochemical similarity between the testicular and ovarian Granulosa Cell Tumors.

Cytomorphology of adult granulosa cell tumor in ascitic fluid.

Adult granulosa cell tumors (AGCT) are associated with ascites in 10% of the cases. Although these tumors form two per cent of all ovarian tumors, they may create a diagnostic challenge in cytologic preparations. The tumor cells are not readily shed in the fluid. A case of a 47-year-old woman with presence of granulosa tumor cells in ascitic fluid is presented. Because of its rarity, AGCTs can be confused with other ovarian tumors.

Two Cases of Granulosa Cell Tumor of the Ovary / 대한산부인과학회지

Granulosa cell tumors are relatively low-grade malignancies accounting for about 1 to 2% of all primary ovarian neoplasms and have an indolent growth pattern. There are two types of tumors, adult type granulosa cell tumor (AGCT) and juvenile type granulosa cell tumor (JGCT), and each tumor reveals different clinical or histopathological features. The clinical manifestations are mostly associated with estrogen produced by tumor, which are vaginal bleeding or menstrual irregularity in AGCT and precocious puberty in JGCT. Although most patients are diagnosed in early stage with favorable prognosis, some recur after several years. So, continuous follow up is required. Recently, we experienced two cases of adult type granulosa cell tumor and report with a brief review of literatures.

5 Cases of Granulosa Cell Tumors of the Ovary / 대한산부인과학회잡지

Sex cord stromal tumors (GCT) of the ovary compose just 5% of ovarian tumors. Most of them are granulosa cell tumors (GCT). There are two types of tumors, juvenile (JGCT) and adult type (AGCT), which have different clinical and histopathological features. JGCT represents only 5% of GCT. GCT is characterized by secretion of estrogen. Patients may present with vaginal bleeding in adult type, and sexual pseudoprecocity in juvenile type, as results of prolonged exposure to tumor-derived estrogen. Surgery is a principle of treatment and required for definite tissue diagnosis, staging, and tumor debulking. Survival of patients with GCT is generally excellent because most patients present with early stage disease. Because of the propensity of GCT to recur years after initial diagnosis, prolonged surveillance such as physical examination and serum tumor markers such as estradiol and inhibin is reasonable. We present 5 cases GCT, 4 AGCT and 1 JGCT, with brief review of literature.

A case of Adult Granulosa Cell Tumor associated with Endometrial Carcinoma / 대한산부인과학회잡지

Granulosa cell tumors of the ovary are rare neoplasms, which account for 2-3% of all ovarian malignancies. There are two types of granulosa cell tumors, adult type and juvenile type. The patients with adult granulosa cell tumors present symptoms of metrorrhagia and amenorrhea due to high serum estrogen level, and maybe accompanied by endometrial hyperplasia in one third of cases and endometrial cancer in 10% of cases. Endometrial cancers have two different pathogenetic types, estrogen-dependent tumors with a history of exposure to unopposed estrogen, and estrogen-independent tumors. In patients with granulosa cells tumors, estrogen-dependent endometrial cancers can be found and most of these endometrial cancers are well differentiated, endometrioid adenocarcinoma and good prognosis due to early detection Although it is known that granulosa cell tumors with endometrial cancers are found in 10% of cases, Finn et al. found no cases of granulosa cell tumors with endometrial cancers. Heric et al. reported 5 of 54 cases of granulosa cell tumors with endometrial cancers, and recently Monzer et al. reported one such case. As we expeirence a case of adult granulosa cell tumor associated with endometrial cancer, we report our case with a literature review.