Rustamadji Primariadewi, Wiyarta Elvan, Anggraeni Tricia Dewi, Siregar Trifonia Pingkan
Department of Pathological Anatomy, Dr. Cipto Mangunkusumo National General Hospital, Central Jakarta 10430, Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Central Jakarta 10430, Jakarta, Indonesia.
Int J Surg Case Rep. 2021 Nov;88:106531. doi: 10.1016/j.ijscr.2021.106531. Epub 2021 Oct 19.
Granulosa cell tumor (GCT) is a rare neoplasm that is divided into adult GCT (AGCT) and juvenile GCT (JGCT). Generally, a patient will only have the AGCT or JGCT subtypes. Here, we presented the first case of AGTC accompanied by focal JGTC in a postmenopausal woman.
A 63-year-old postmenopausal woman came with distended abdomen accompanied by postmenopausal bleeding. CT scan shows a solid mass with cystic degeneration. Laparotomy found a solid mass from the right ovary measuring 18 × 15 × 14 cm. The pathological results showed a diffuse tumor representing AGCT, accompanied by Call-Exner bodies and nuclear groove. In addition, minor foci were also found, which consist of well-defined margins tumor and follicular-like structures that resemble JGCT. The patient underwent bilateral salpingo-oophorectomy with a total hysterectomy and no recurrence in three months follow-up.
Age and clinical symptoms cannot be used as specific differentiators between AGTC and JGTC. Radiological imaging also shows a similar appearance of solid masses tumors with hemorrhagic or fibrotic changes, multilocular cystic lesions, or completely cystic tumors. The concomitant findings of JGCT and AGCT could be distinguished very carefully by anatomical pathology examination. It is crucial to differentiate AGCT from JGCT, especially to see the prognosis.
The role of pathologists is needed in differentiating AGCT and JGCT, primarily when found simultaneously.
颗粒细胞瘤（GCT）是一种罕见的肿瘤，分为成人颗粒细胞瘤（AGCT）和青少年颗粒细胞瘤（JGCT）。一般来说，患者只会有AGCT或JGCT亚型。在此，我们报告了首例绝经后女性同时患有AGCT并伴有局灶性JGCT的病例。
一名63岁的绝经后女性因腹部膨隆并伴有绝经后出血前来就诊。CT扫描显示一个伴有囊性变的实性肿块。剖腹探查发现右侧卵巢有一个实性肿块，大小为18×15×14厘米。病理结果显示为弥漫性肿瘤，代表AGCT，伴有Call-Exner小体和核沟。此外，还发现了较小的病灶，由边界清晰的肿瘤和类似JGCT的滤泡样结构组成。患者接受了双侧输卵管卵巢切除术及全子宫切除术，术后三个月随访未复发。
年龄和临床症状不能作为区分AGTC和JGTC的特异性指标。放射影像学检查也显示实性肿块肿瘤有类似的表现，伴有出血或纤维化改变、多房囊性病变或完全囊性肿瘤。JGCT和AGCT的并存情况可通过解剖病理学检查非常仔细地区分。区分AGCT和JGCT至关重要，尤其是对于判断预后。
在区分AGCT和JGCT时需要病理学家的参与，尤其是当两者同时发现时。
