Kaur Harpreet, Bagga Rashmi, Saha Subhash Chandra, Gainder Shalini, Srinivasan Radhika, Adhya Amit K, Dhaliwal Lakhbir Kaur
Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Int J Clin Oncol. 2009 Feb;14(1):78-81. doi: 10.1007/s10147-008-0805-z. Epub 2009 Feb 20.
Juvenile granulosa cell tumor (GCT) is a rare tumor, and the majority (90%) are reported in the prepubertal or under-30-year age group, in contrast to the adult type, which is more common in the fifth decade. On histopathological examination, juvenile GCTs are distinct from the adult type of GCT, and have a lower risk for late recurrences than the latter. Being solid tumors, they may be associated with ascites and pleural effusion (Meigs' syndrome), which resolve after surgical removal of the tumor. Tumor markers for GCT are still investigational (inhibin) and of not much use in making a preoperative diagnosis, unlike in the case of germ cell tumors. In most of the reports about the initial surgical management of GCT, retroperitoneal lymph node sampling was not performed, and it was not done in the patient we report here. However, lymph node sampling is advocated for complete staging of these tumors, as a significant number of recurrences are reported in the retroperitoneum, as well as in incompletely staged patients. In the present patient, because of the association of Meigs' syndrome, a preoperative diagnosis of benign tumors such as fibroma/thecoma was also considered. We report this rare tumor with an aim of reviewing the diagnosis and management from the reported literature.
青少年颗粒细胞瘤（GCT）是一种罕见肿瘤，多数（90%）报告发生于青春期前或30岁以下年龄组，而成人型GCT在50岁左右更为常见。组织病理学检查显示，青少年GCT与成人型GCT不同，其晚期复发风险低于后者。作为实体瘤，它们可能伴有腹水和胸腔积液（梅格斯综合征），肿瘤手术切除后这些症状会消失。GCT的肿瘤标志物仍在研究中（抑制素），与生殖细胞肿瘤不同，其在术前诊断中作用不大。在大多数关于GCT初始手术治疗的报告中，未进行腹膜后淋巴结采样，我们报告的该患者也未进行此项操作。然而，鉴于有大量复发报告发生于腹膜后以及分期不完全的患者中，提倡对这些肿瘤进行淋巴结采样以完成分期。在本例患者中，由于存在梅格斯综合征，术前也考虑过纤维瘤/卵泡膜瘤等良性肿瘤的诊断。我们报告这例罕见肿瘤，目的是根据已发表文献回顾其诊断和治疗。
