Original Research Paper

Juvenile Granulosa Cell Ovarian Tumor Presenting as Secondary Amenorrhea in a Adolescent Girl : A Rare Case Report

  Abstract :

Granulosa cell tumors are rare, functional sex cord-gonadal stromal tumors. There are two subtypes of granulosa cell tumor-the more common adult granulosa cell tumor and the rare subtype juvenile granulosa cell tumor. Juvenile granulosa cell tumors have varied clinical presentation due to hormone production by the tumor cells.A 15-year-old unmarried female presented with secondary amenorrhea, abdominal lump, and lower abdominal pain. There were no signs of hirsutism, and the pregnancy test was negative. Ultrasonography and computed tomography revealed a large left ovarian cyst. The patient underwent exploratory laparotomy, surgical staging, and left salpingo-oophorectomy. FIGO surgical stage of tumor was stage 1A. Histopathological examination revealed juvenile granulosa cell ovarian tumor. The patient resumed her menstrual cycle shortly after the surgery. Follow up was done with serum inhibin levels and intermittent imaging. Our index case had a purely cystic lesion and presenting with secondary amenorrhea, which are uncommon for this tumor.Juvenile granulosa cell tumor, when diagnosed at an early stage, carries an excellent prognosis. The clinical suspicion of granulosa cell tumor should be kept in mind whenever a child or young woman presents with signs and symptoms of hormonal excess along with a large unilateral adnexal mass. Significantly elevated serum estradiol levels, in the absence of pregnancy, are indicative of an estrogen-secreting tumor. Early diagnosis facilitates complete resection of tumor and preservation of female reproductive potential, which is a prime concern in this age group.

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