Department of Population Health and Reproduction, School of Veterinary Medicine, University of California at Davis, Davis, CA, USA.
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Equine Vet J. 2021 Jan;53(1):60-70. doi: 10.1111/evj.13279. Epub 2020 Jun 10.
Granulosa cell tumours (GCT) are the most common ovarian tumours in mares. While the classical presentation may not represent diagnostic challenges, diagnosis is not easy in the early stages.
Illustrate the variability in the presentation and serum biomarkers associated with ovarian abnormalities in the mare.
Retrospective case series.
Nonclassical cases of GCTs and other ovarian conditions were identified and behaviour, GCT endocrine results, palpation and ultrasonographic findings are described and the diagnostic value of each is discussed.
Mares in this case series with GCTs had been presenting clinical signs ranging from no behavioural changes to behaviours including aggression, stallion-like and inability to work under saddle. Hormonal profiles of endocrinologically functional GCTs can be erratic and unpredictable. The clinical form and ultrasonographic appearance may also vary with time from an initially enlarged/anovulatory follicular structure that later develops a multicystic 'honeycomb' appearance. Mares with GCTs can also present with persistent anovulatory follicles or apparent luteal tissue that are unresponsive to treatment. If both ovaries are of relatively normal size and symmetry, but hormonal biomarkers are markedly increased (AMH >10 ng/mL, inhibin B and/or testosterone >100 pg/mL; 0.37 nmol/L), it is likely that a functional GCT is present. Still, it can be a challenge to decide which ovary to remove. Post-surgical endocrine testing can be helpful, especially if histopathology is not performed or a GCT is not found.
Cases limited to 14.
Granulosa cell tumours present with a wide variety of clinical signs that do not fit what is commonly described as 'classic'. Only if AMH, testosterone and inhibin B concentrations are markedly increased, and there is an abnormally enlarged ovary, the diagnosis of a GCT is more confident. In the presence of normal size ovaries, normal hormonal biomarkers and abnormal behaviour, it is more likely that the ovaries are not involved.
颗粒细胞瘤（GCT）是母马最常见的卵巢肿瘤。虽然经典表现可能不会带来诊断挑战，但在早期阶段诊断并不容易。
说明与母马卵巢异常相关的表现和血清生物标志物的可变性。
回顾性病例系列。
确定非典型 GCT 和其他卵巢疾病病例，并描述其行为、GCT 内分泌结果、触诊和超声检查结果，并讨论每种方法的诊断价值。
本病例系列中的 GCT 患马的临床表现从无行为变化到表现出攻击性、种马样和无法在马鞍下工作等行为。内分泌功能 GCT 的激素谱可能不稳定且不可预测。临床形式和超声表现也可能随时间而变化，从最初增大/无排卵卵泡结构发展为多囊“蜂巢”外观。GCT 患马也可能出现持续无排卵卵泡或明显黄体组织，对治疗无反应。如果两个卵巢相对正常大小和对称，但激素生物标志物明显增加（AMH>10ng/mL，抑制素 B 和/或睾酮>100pg/mL；0.37nmol/L），则很可能存在功能性 GCT。尽管如此，决定切除哪一侧卵巢仍然具有挑战性。术后内分泌测试可能会有所帮助，特别是如果未进行组织病理学检查或未发现 GCT。
病例仅限于 14 例。
颗粒细胞瘤表现出各种与通常描述的“经典”不符的临床表现。只有当 AMH、睾酮和抑制素 B 浓度明显增加，并且卵巢异常增大时，GCT 的诊断才更有信心。在卵巢大小正常、激素生物标志物正常和异常行为的情况下，更有可能是卵巢未受影响。
