Juvenile Granulosa cell tumor; a report of two cases for such a rare neoplasm in a pediatric age group

Abstract

Mohammed J. Aboud

Background: Granulosa cell tumor (GCT) is the most common sex cord-stromal tumor that stems from granulosa cells. It comprises only 5% of ovarian tumors of childhood or adolescence. We reported two cases diagnosed with juvenile GCT (JGCT) to highlight the clinical presentation, histopathological characteristics of this rare tumor, and to remind the pediatric surgeon and the pediatrician of the necessity to achieve and follow the correct workup. Case 1: A 2.8 years old female presented to the pediatric surgery clinic with symptoms of vomiting, cramping with lower abdominal pain, enlargement of the bilateral breast, and abnormal vaginal discharge for 2 months. The diagnosis of JGCT-stage IA was established. Case 2: A 3.4 years old girl was admitted to the Pediatric surgery unit, presented with pallor, abdominal pain, and non-bilious vomiting of 2 days duration. Abdominal exploration was decided and the tumor was totally excised (unilateral salpingo-oophorectomy). The clinical and histopathological studies were compatible with JGCT stage IC. Conclusion: The ovarian JGCT is a rare pathology in the pediatric age group. Staging according to the presentation, surgical and histopathologic parameters are an important prognostic factor. Surgery is still the cornerstone in the decision making of the management strategy while adjuvant therapy is initiated in the advanced stages.