青少年颗粒细胞瘤的非典型表现：病例报告。
Atypical Presentation of Granulosa Cell Tumor in an Adolescent: A Case Report.
机构信息
Department of Surgery, Division of Pediatric and Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
出版信息
J Pediatr Adolesc Gynecol. 2023 Dec;36(6):553-555. doi: 10.1016/j.jpag.2023.06.007. Epub 2023 Jun 22.
BACKGROUND
Granulosa cell tumors (GCTs) frequently present with elevated levels of estrogen and inhibin. Most diagnoses in the pediatric and adolescent population are juvenile-type GCTs; adult-type GCTs in this population are rare.
CASE
We describe a 14-year-old female who presented with a large adnexal mass and clinical hyperandrogenism. Laboratory evaluation revealed elevated levels of free and total testosterone, low-normal estradiol, and mildly elevated alpha-fetoprotein (AFP). Other tumor markers, including inhibin, were within normal limits. Intraoperative assessment with unilateral oophorectomy, pathology, and imaging resulted in a diagnosis of a stage IA adult-type GCT.
SUMMARY AND CONCLUSION
GCTs often result in elevated estrogen and inhibin B levels; however, this case demonstrates that non-classic elevations in testosterone and normal inhibin levels should not eliminate concern for a GCT, particularly in the setting of a large ovarian mass.
背景
颗粒细胞瘤（GCT）常表现为雌激素和抑制素水平升高。儿科和青少年人群中的大多数诊断为幼年型 GCT；该人群中罕见成年型 GCT。
病例
我们描述了一名 14 岁女性，她表现为附件区巨大肿块和临床高雄激素血症。实验室检查显示游离和总睾酮升高，雌二醇正常低值，甲胎蛋白（AFP）轻度升高。其他肿瘤标志物，包括抑制素，在正常范围内。单侧卵巢切除术、病理和影像学的术中评估导致诊断为 IA 期成人型 GCT。
总结和结论
GCT 常导致雌激素和抑制素 B 水平升高；然而，本例表明，睾酮非典型升高和抑制素水平正常不应排除 GCT 的可能性，特别是在存在大的卵巢肿块的情况下。
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