Granulosa cell tumours of the ovary are a type of sex cord / stromal ovarian tumour.
Sex cord-stromal tumours represent approximately 8% of all ovarian tumours and are believed to arise from and/or to contain combinations of the sex cord and stromal components of the developing gonad. Granulosa cell tumours of the ovary comprise a distinct subset of ovarian cancers that account for approximately 5% of all ovarian malignancies 6.
Patients may present with nonspecific symptoms such as abdominal pain, distention, or bloating. In a majority of cases, there may be hormonal manifestations due to oestrogen activity of the tumour 6.
They are thought to arise from normal proliferating granulosa cells of the late preovulatory follicle and exhibit many morphological and biochemical features of these cells. GCT are distinct from other ovarian carcinomas in their hormonal activity; their ability to secrete oestrogen, inhibin, and Müllerian inhibiting substance accounts for some of the clinical manifestations of the disease and also provides useful tumour markers for disease surveillance 6.
- the hyperoestrogenemia may produce
- Maffucci syndrome: with juvenile granulosa cell tumour
It can be divided into two broad subtypes:
- adult granulosa cell tumour of the ovary: much more common and accounts for ~95% of cases 5
- juvenile granulosa cell tumour of the ovary
They are slow-growing, predominantly solid masses with variable amounts of cystic change and intratumoral haemorrhage. Bilaterality is rare.
Oestrogenic effects on the uterus may manifest as uterine enlargement or as endometrial thickening or haemorrhage.6
- appearance varies widely: may appear anywhere from a solid mass to a multiloculated solid and cystic mass, to a purely cystic lesion
- varying degrees of haemorrhage or fibrosis
- less likely to have intracystic papillary projections than epithelial ovarian tumours
The CT appearance of a granulosa cell tumour is usually that of a large, well-defined low-attenuation ovarian mass.
Treatment and prognosis
It is suggested that stage I granulosa cell tumours should go for fertility-sparing surgery, unilateral salpingo-oophorectomy appears to be the most appropriate course of action.6
- 1. Kim SH, Kim SH. Granulosa cell tumor of the ovary: common findings and unusual appearances on CT and MR. J Comput Assist Tomogr. 26 (5): 756-61. J Comput Assist Tomogr (link) - Pubmed citation
- 2. Rha SE, Oh SN, Jung SE et-al. Recurrent ovarian granulosa cell tumors: clinical and imaging features. Abdom Imaging. 33 (1): 119-25. doi:10.1007/s00261-007-9197-1 - Pubmed citation
- 3. Morikawa K, Hatabu H, Togashi K et-al. Granulosa cell tumor of the ovary: MR findings. J Comput Assist Tomogr. 21 (6): 1001-4. J Comput Assist Tomogr (link) - Pubmed citation
- 4. Saini A, Dina R, Mcindoe GA et-al. Characterization of adnexal masses with MRI. AJR Am J Roentgenol. 2005;184 (3): 1004-9. AJR Am J Roentgenol (full text) - Pubmed citation
- 5. Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
- 6. Jamieson S, Fuller PJ. Molecular pathogenesis of granulosa cell tumors of the ovary. Endocr. Rev. 2012;33 (1): 109-44. doi:10.1210/er.2011-0014 - Pubmed citation
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Ultrasound - gynaecology
- ultrasound (introduction)
- acute pelvic pain
- chronic pelvic pain
- Mullerian duct anomalies
- ovarian follicle
- ovarian torsion
- pelvic inflammatory disease
- ovarian cysts and masses
- ovarian cyst
- corpus luteum
- haemorrhagic ovarian cyst
- ruptured ovarian cyst
- ovarian epithelial tumours
- granulosa cell tumours of the ovary
- paraovarian cyst
- polycystic ovaries
- ovarian hyperstimulation syndrome
- post-hysterectomy ovary
- fallopian tube