[Adult type granulosa cell testicular tumor. Case report and bibliographic review.] / Tumor de células de la granulosa testicular de tipo adulto. Presentación de un nuevo caso y revisión de la literatura.

OBJETIVE: To describe the adult type granulosa cell testicular tumors (classified as sex cordstromal tumor) due to their behavior, hardly known with a small number of cases reported. METHOD: We report a new case of a 59-year-old man presenting an adult type granulosa cell tumor of the testis (AGCTT), painless, with a 3.3 centimeter intratesticular heterogeneous mass on ultrasound, with solid and cystic areas. Serum tumor markers and extension study were negative. RESULTS: Histologic and inmunohistochemical studies confirmed an AGCTT, similar to its ovarian counterpart. CONCLUSION: AGCTT are rare neoplasms with unpredictable behavior. Their metastatic potential has been described, reason why they need a long follow-up; however, they usually have a good prognosis.

Granulosa cell tumors of the ovary with a pseudopapillary pattern: a study of 14 cases of an unusual morphologic variant emphasizing their distinction from transitional cell neoplasms and other papillary ovarian tumors.

Granulosa cell tumors of the ovary with a pseudopapillary pattern have received only passing mention in the literature. We have reviewed the clinicopathologic features of 10 cases of juvenile granulosa cell tumor and 4 cases of adult granulosa cell tumor with a pseudopapillary pattern. Twelve cases were received in consultation; the referring pathologist favored a diagnosis of a transitional cell neoplasm in 3 of these cases, and a retiform Sertoli-Leydig cell tumor in 2 cases; in most of the remainder, the diagnosis of granulosa cell tumor was considered but uncertainty expressed because of the unusual papillarylike pattern. All 14 tumors were unilateral, and the majority were predominantly cystic, 3 unilocular, and 6 multilocular. Multiple papillary projections lining the cyst wall were noted grossly in 10 cases; these ranged in size from 0.1 to 1.5 cm and were typically soft, edematous, fleshy, or rubbery. Microscopically, pseudopapillae were formed by intracystic cellular projections with surrounding necrotic debris and/or undulating folds of neoplastic cells in the absence of appreciable necrosis. In all tumors, thorough sampling revealed areas with architectural patterns and cytomorphology typical of granulosa cell tumor. Granulosa cell tumors of adult and juvenile type may have a pseudopapillary pattern that can be confused with other ovarian tumors with a papillary architecture. Identification of areas that are more characteristic of granulosa cell tumor resolves most cases, although immunohistochemistry can be used in more problematic tumors. This phenomenon seems to be related to the cystic change that is a feature of many granulosa cell tumors.

Recurrent juvenile granulosa cell tumor of the ovary managed by palliative radiotherapy.

Prognosis in the few patients with advanced-stage juvenile granulosa cell tumor (JGCT) of the ovary has traditionally been unfavorable. We report a recurrent JGCT patient managed by palliative radiotherapy. A 37-year-old woman with recurrent JGCT received a combination of paclitaxel-carboplatin chemotherapy and then single-agent docetaxel, but her disease progressed with multiple abdominal masses and ascites. We chose palliative radiation therapy to relieve her complaints. Whole-abdominal external beam radiotherapy with pelvic boost was delivered. She tolerated the treatment well. After the completion of radiotherapy, ultrasonography showed shrinkage of the tumor, and the ascites disappeared. We should consider using radiation therapy in a palliative setting for such patients with recurrent JGCT suffering from abdominal complaints.

Recent advances in the pathology and classification of ovarian sex cord-stromal tumors.

In recent years, our knowledge of ovarian sex cord-stromal tumors has increased, and their classification has evolved. In this review, recent advances in the classification and pathology of ovarian sex cord-stromal tumors are discussed, and the controversy regarding the classification of sex cord tumor with annular tubules is addressed. The current classification is built on those of the past, and future classifications should improve on what is now in place incorporating new knowledge from more sophisticated clinicopathologic studies and advanced molecular techniques. This review emphasizes articles written in the 21st century as well as those that have significantly advanced our knowledge of sex cord-stromal tumors in past decades. The tumors in this group occur over a wide age range and are often unilateral. In difficult cases, immunocytochemistry provides improved diagnostic accuracy. The most useful immunohistochemical marker for their identification is alpha-inhibin, which is positive in most neoplasms in the sex cord-stromal group. The article concludes with a section discussing the pathogenesis of sex cord-stromal tumors.

Inhibin and activin are demonstrable by immunohistochemistry in ovarian tumor tissue.

Elevated serum immunoreactive inhibin concentrations have been reported in patients with mucinous and granulosa cell tumors of the ovary. The present study aimed to determine whether the inhibins and/or the related peptides, the activins, were demonstrable within ovarian tumor tissue. Immunohistochemical analyses were performed on 11 ovarian tumors, 5 mucinous, 3 serous, 1 granulosa, 1 clear cell, and 1 metastatic colonic cancer. Both monoclonal and polyclonal antisera specific for inhibin-A, activin-A, and activin-B, and their alpha-, beta A- and beta B-subunits were used. The mucinous cells of all five mucinous tumors showed positive staining for activin-A and activin-B, and their beta A- and beta B-subunits, and three stained positive for inhibin-A and the alpha-subunit. The granulosa cell tumor also showed positive staining for inhibin-A and the activins. The remaining tumors were negative. The findings are consistent with the hypersecretion of inhibin (and possibly activin) by some ovarian malignancies and suggest that immunohistochemistry for the inhibins and the activins should be explored further in the classification of ovarian malignancies.

Tumor de células granulosas doble localización en lengua / Granular cell tumor: double localization on the tongue

El tumor de células granulosas es una neoformación de curso habitualmente benigno. Entidad clínica infrecuente y de histología definida. Su localización principal es en mucosa bucal, sobre todo en lengua, piel y tejido celular subcutáneo; menos frecuente en distintos órganos. Se presenta como un tumor único, noduloide, asintomático,duro y pequeño. Presentamos un caso de sexo masculino, caracterizado por tener dos tumores aislados, localizados en ambos bordes de la lengua; uno de aspecto noduloide ulcerado, y el otro tipo placa indurada, de dos años y medio de evolución, doloroso al roce y a la palpación. Ambos fueron extirpados quirúrgicamente, sin recaídas

Tumor de células granulosas doble localización en lengua / Granular cell tumor: double localization on the tongue

El tumor de células granulosas es una neoformación de curso habitualmente benigno. Entidad clínica infrecuente y de histología definida. Su localización principal es en mucosa bucal, sobre todo en lengua, piel y tejido celular subcutáneo; menos frecuente en distintos órganos. Se presenta como un tumor único, noduloide, asintomático,duro y pequeño. Presentamos un caso de sexo masculino, caracterizado por tener dos tumores aislados, localizados en ambos bordes de la lengua; uno de aspecto noduloide ulcerado, y el otro tipo placa indurada, de dos años y medio de evolución, doloroso al roce y a la palpación. Ambos fueron extirpados quirúrgicamente, sin recaídas

Fine needle aspiration cytology of ovarian sex cord tumor with annular tubules.

The clinical and cytopathologic features of a case of ovarian sex cord tumor with annular tubules are presented. To the best of our knowledge, this is the first report describing the cytologic features in a fine needle aspirate. Aspiration cytology cannot distinguish this tumor with certainty from a granulosa-cell tumor.