An Unusual Presentation of a Juvenile Granulosa-Cell Tumor

Abstract

Abstract

Background:

Juvenile granulosa-cell tumors (JGCTs) are rare. Commonly, they are associated with hyperestrogenic features. However, these tumors rarely manifest with virilizing features and bleeding necrotic tumors. Sonographic similarities are common among juvenile granulosa-cell tumors and benign juvenile ovarian cysts.

Case:

A 20-year-old woman presented with acute anemia, abdominal pain, and a large pelvic mass that was diagnosed at surgery as a JGCT.

Results:

This patient had an unremarkable postoperative course. Histopathology testing revealed that she did have a JGCT. She was referred for an oncology consultation.

Conclusions:

Imaging findings in JGCT may resemble those of benign ovarian masses; thus, a high index of suspicion is required. JGCT should be included in the differential diagnosis when anemia is present. A thorough preoperative evaluation—including measurements of tumor markers (e.g., inhibin) and serum hormone levels (testosterone)—is warranted in order to characterize the lesion better and prepare the patient for optimal surgical staging.