Ovarian granulosa cell tumor : a clinicopathological series

Abstract

Introduction: Granulosa cell tumours (GCT) are uncommon neoplasms, accounting for 2-5% of all ovarian carcinomas. The pathogenesis of these tumours is characterised by differentiation towards the follicular granulosa cell. However, the exact cell of origin is disputed, with the granulosa cell, thecal cell or fibroblast having been proposed as putative progenitors. A granulosa stem-cell has been described, which has also been suggested as a cell of origin. Approximately 65% of patients are postmenopausal at the time of diagnosis and, in these patients, the morphology of the tumour conforms to the so-called adult-type GCT. A minority of tumours, however, present at a younger age, and these tumours typically exhibit juvenile-type GCT morphology. However, this is by no means a pathological dogma and both tumour forms have been described at any age. This case series includes all cases of ovarian GCT diagnosed at Mater Dei Hospital, Malta, between 2008 and 2016. GCT cases were identified through the hospital histopathological records after the appropriate data protection clearance. This case series aims to showcase the variable natural history and presenting features of juvenile-type and adult-type GCTs, while emphasising the need for indefinite long-term follow up protocols.