Clinical history: A 38 year old female with a 7 cm ovarian mass. Cut surface of the mass showed solid fleshy areas cystic areas and hemorrhage
What is your diagnosis?
Discussion and answers
Diagnosis – Mixed adult and juvenile granulosa cell tumour
Microscopically the lesion showed areas composed of sheets of cells interspersed with
multiple small cystic spaces containing proteinaceous to hemorrhagic material. The neoplastic cells
In these areas contain abundant eosinophilic to vacuolated cytoplasm and rounded nuclei, showing
mild pleomorphism and moderately increased mitotic activity. The histological features present in this
area are consistent with a granulosa cell tumour, of juvenile type (A,B). In other areas, the tumour
consists of cells with scanty cytoplasm, oval to angulated uniform nuclei, showing nuclear grooves and
occasional mitoses. The cells are arranged in the form of microfollicles with Call-Exner bodies and
trabecularstructures. These areas represent a component of adult type granulosa cell tumor (C,D).
Granulosa cell tumors may sometimes exhibit a mixed pattern of the adult and juvenile histologic
types, as seen in this case.
The immunohistochemical stains performed, show diffuse strong positive staining for Inhibin and
Calretinin in the tumor cell population.The tumor cells show negative staining for pancytokeratin