Juvenile granulosa cell tumor (ovary)

Last revised by Joshua Yap on 11 May 2023

Juvenile granulosa cell tumors of the ovary (JGCT) are a less common subtype of granulosa cell tumor of the ovary (~5% of cases). They are classified as ovarian sex cord / stromal tumors.

It typically occurs in premenarchal girls and young women. The mean age of presentation is 13 years.

Juvenile granulosa cell tumors of the ovary typically produce precocious puberty as a consequence of estrogen secretion. Rarely, they produce androgenic hormones.

  • the appearance varies widely: may appear anywhere from a solid ovarian mass, to a multiloculated solid and cystic mass, to a purely cystic lesion

  • varying degrees of hemorrhage and/or fibrosis

  • typically unilateral

  • less likely to have intracystic papillary projections than epithelial ovarian tumors

  • "sponge-like" appearance 

    • solid areas of intermediate T2 signal intensity

    • multilocular cystic component

    • increased T1 signal in multiple locules, compatible with hemorrhage into the cystic locule

Uterine enlargement and/or endometrial thickening may also be present.

Most juvenile granulosa cell tumors of the ovary (~90%) are detected at a low stage and surgery is curative. Higher-stage disease has a worse prognosis and may require chemotherapy 7.

Inhibin can be used as a serum marker for diagnosis and post-treatment follow-up.

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