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Adult Granulosa Cell Tumor : Clinical Features - II

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Clinical Presentation of Adult Granulosa Cell Tumor (GCT) (continued from the previous image): Besides the features presented previously, the patients may also develop breast tenderness, swelling and nipple discharge. About 10% of cases, usually cystic tumors seen in younger women (15-35 years of age), are androgenic and produce virilization (hirsutism, clitoral hypertrophy, deepening of voice, and amenorrhea). The rare prepubertal patients who develop adult GCT present with isosexual precocious puberty. A small percentage of adult GCTs are hormonally inactive.

Besides hormonal manifestations, adult GCT can cause a palpable pelvic mass, abdominal pain, and swelling. The clinical course is complicated by tumor rupture in 10% of cases, resulting in acute abdominal pain and hemoperitoneum. Serum beta-inhibin levels are elevated and are useful in monitoring for recurrences.

Case History: This image shows non-atypical endometrial hyperplasia from a 39 y/o woman who presented with menorrhagia and was subsequently found to have an adult GCT.

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