Virilization persists in a woman with an androgen-secreting granulosa cell tumor

Patel, Samir P.; Carrick, Kelley; Carr, Bruce R.

doi:10.1016/j.fertnstert.2008.10.038

Cited by 16 publications

(6 citation statements)

References 11 publications

(13 reference statements)

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“…The granulosa cell tumors are often unilateral, solid, well-differentiated and have a small malignant potential. 14 The diagnosis of granulosa cell tumors is based on the clinical presentation of the illness, and additional diagnostic procedures such as ultrasonography, magnetic resonance imaging or computed tomography. The differential diagnosis should exclude diseases of the other parts of the endocrine system, especially the pituitary and adrenal glands.…”

Section: Discussionmentioning

confidence: 99%

Juvenile Type Granulosa Cell Tumor

Andric¹,

Arsenijevic

Jovic

et al. 2018

Serbian Journal of Experimental and Clinical Research

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Granulosa cell tumor is a type of neoplasm, which represents 2-5% of all ovarian cancers. About 5% of these tumors are juvenile- type and usually occur to girls before puberty and to women younger than thirty years of age. There are signs premature puberty or premature emergence of secondary sexual characteristics with irregular vaginal bleeding that occur to these kind of patients. To the rare cases, like this, the occurrence of granulosa cell tumors can cause the appearance of hyperandrogenism with high levels of plasma testosterone, leading to virilization which happened to this female patient. We will present the female patient who was 35 years old and which was originally hospitalized to the Clinic for Haematology Clinical Center Kragujevac, because of extreme fatigue accompanied by dizziness. During diagnostics the patient underwent to the complete gynecological examination. After gynecological examinations and necessary diagnostic procedures, it was decided continuing the treatment at the Clinic of Gynecology and Obstetrics Clinical Center Kragujevac, where she underwent a total abdominal hysterectomy with bilateral salpingo- oophorectomy for suspected uterine neoplasm. Histopathological analysis of the obtained material confirmed the presence of follicular cysts of both ovaries and juvenile type granulosa cell tumor on the right ovary; the uterus was enlarged with multiple fibroid tumors. Granulosa cell tumor should be suspected in the cases of girls and young females if there is present an ovarian cyst paired with signs of preterm puberty or hyperestrogenism. In this case, the presence of granulosa cell tumor was masked by signs of hyperandrogenism, which is not so typical, as well as the presence of uterine fibroids who have actually been the main cause for surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Juvenile Type Granulosa Cell Tumor

Andric¹,

Arsenijevic

Jovic

et al. 2018

Serbian Journal of Experimental and Clinical Research

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“…Clinical manifestations of estrogen-producing tumors are amenorrhea, dysfunctional menstrual bleeding, growth of uterine leiomyomas, hyperplasia of the endometrium, or endometrial cancer. The symptoms and signs of the rare virilizing GCTs are primary or secondary amenorrhea, hirsutism, clitoris hypertrophy, deepening of the voice, muscular development and acne due to elevated testosterone levels (11).…”

Section: Discussionmentioning

confidence: 99%

Rare virilizing granulosa cell tumor in an adolescent

Bús¹,

Buzogány²,

Nagy³

et al. 2016

Molecular and Clinical Oncology

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Abstract. Hormone-producing malignancies are rare in children or adolescent patients: Only 0.1% of all ovarian tumors and 4-5% of granulosa cell tumors occur in the sexually non-active ages. Granulosa cell tumors (GCTs) are sex cord-stromal tumors of the ovary, representing 7-8% of all ovarian neoplasms. A total of 95% of all GCTs are adult-type, and only 5% are diagnosed as juvenile-type GCT. A majority of children with juvenile-type GCT present with isosexual precocious pseudopuberty due to excessive estrogen production, although virilizing, testosterone-producing, juvenile-type GCTs are rare, occurring only in 2-3% of cases. The present case study reports on a case of a virilizing, juvenile-type GCT in a 14-year-old girl, along with a review of the literature.

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“…Although hyperandrogenism in granulosa cell tumors of the ovary has been reported by several investigators [1,7,8,18,19,20,21,22], its pathophysiology has not been elucidated so far. We recently showed that low or absent expression of SOX9 along with aberrant expression of FOXL2 in granulosa cell tumors of the testis could be associated with a transdifferentiation of tumoral cells from male to female type [9].…”

Section: Discussionmentioning

confidence: 99%

Unusual Virilization in Girls with Juvenile Granulosa Cell Tumors of the Ovary Is Related to Intratumoral Aromatase Deficiency

Kalfa¹,

Meduri

Philibert³

et al. 2010

Horm Res Paediatr

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Background: Hyperandrogenism is a rare symptom of juvenile ovarian granulosa cell- tumors (JGCTO). This study aimed to determine whether hyperandrogenism was related to overexpression of SOX9, decreased expression of FOXL2 or absent aromatase expression in tumor with particular scheme of expression of P450scc and P450c17α. Methods: Through a nationwide study including the French Society of Pediatric Oncology, 6/30 patients with JGCTO presented with clinical hyperandrogenism and high plasma testosterone. Tumor specimens underwent immunofluorescence (SOX9, FOXL2) and immunochemistry (aromatase, P450scc, P450c17α). Results were compared with patients without hyperandrogenism. Results: SOX9 was expressed in the granulosa cell nucleus in 2/6 cases but also in 9/24 tumors without hyperandrogenism (p = n.s.). FOXL2 was absent or decreased in 3/6 cases of JGCTO with hyperandrogenism with no statistical difference from the group without this symptom. In 6/6 patients, the intratumoral expression of aromatase was absent (n = 5) or dramatically reduced (n = 1). In contrast, 15/24 patients without virilization exhibited conserved aromatase expression in their tumor (p < 0.05). A variable number of tumoral cells expressed P450scc while some interstitial cells were focally immunopositive for P450c17α. Conclusion: Unusual virilization in girls with JGCTO is not explained by a dysregulation in SOX9 or FOXL2 expression, but is related to a localized defect of aromatase expression in granulosa cells and to the ability of interstitial cells to produce testosterone.

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Virilization persists in a woman with an androgen-secreting granulosa cell tumor

Cited by 16 publications

References 11 publications

Juvenile Type Granulosa Cell Tumor

Juvenile Type Granulosa Cell Tumor

Rare virilizing granulosa cell tumor in an adolescent

Unusual Virilization in Girls with Juvenile Granulosa Cell Tumors of the Ovary Is Related to Intratumoral Aromatase Deficiency

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