Granulosa-Theca Cell Tumors Differential Diagnoses

  • Author: Chad M Michener, MD; Chief Editor: Warner K Huh, MD   more...
 
Updated: Jan 4, 2010
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Chad M Michener, MD  Assistant Professor, Obstetrics/ Gynecology and Women's Health Institute, Section of Gynecologic Oncology, The Cleveland Clinic

Chad M Michener, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists and Society of Gynecologist Oncologists

Disclosure: Nothing to disclose.

Coauthor(s)

David C Starks, MD  Fellow, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cleveland Clinic Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

Bruce A Meyer, MD, MBA  Executive Vice President for Health System Affairs, Chief Clinical Officer, Interim CEO, University Hospitals; Professor, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical School

Bruce A Meyer, MD, MBA is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Physician Executives, American Institute of Ultrasound in Medicine, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, Medical Group Management Association, and Society for Maternal-Fetal Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Frederick B Gaupp, MD  Consulting Staff, Department of Family Practice, Hancock Medical Center

Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Chief Editor

Warner K Huh, MD  Professor, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Senior Scientist, Comprehensive Cancer Center, University of Alabama School of Medicine

Warner K Huh, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, American Society of Clinical Oncology, Massachusetts Medical Society, and Society of Gynecologist Oncologists

Disclosure: MERCK Consulting fee Consulting; GSK Consulting fee Consulting; ROCHE PHARMA/DIAGNOSTICS Consulting fee Consulting; HOLOGICS Consulting fee Consulting; HELIX BIOPHARMA Consulting fee Consulting; COVIDIEN Consulting fee Consulting; INTUITIVE SURGICAL Surgical Proctor

References

  1. Young RH, Scully RE. Sex cord-stromal, steroid cell, and other ovarian tumors with endocrine, paraendocrine, and paraneoplastic manifestations. In: Kurman RJ, ed. Blaustein's Pathology of the Female Genital Tract. 4th ed. New York, NY: Springer-Verlag; 1994:783-847.

  2. Anttonen M, Unkila-Kallio L, Leminen A, Butzow R, Heikinheimo M. High GATA-4 expression associates with aggressive behavior, whereas low anti-Müllerian hormone expression associates with growth potential of ovarian granulosa cell tumors. J Clin Endocrinol Metab. Dec 2005;90(12):6529-35. [Medline].

  3. Briasoulis E, Karavasilis V, Pavlidis N. Megestrol activity in recurrent adult type granulosa cell tumour of the ovary. Ann Oncol. Aug 1997;8(8):811-2. [Medline].

  4. Brown J, Shvartsman HS, Deavers MT. The activity of taxanes compared with bleomycin, etoposide, and cisplatin in the treatment of sex cord-stromal ovarian tumors. Gynecol Oncol. May 2005;97(2):489-96. [Medline].

  5. Brown J, Sood AK, Deavers MT, Milojevic L, Gershenson DM. Patterns of metastasis in sex cord-stromal tumors of the ovary: Can routine staging lymphadenectomy be omitted?. Gynecol Oncol. Apr 2009;113(1):86-90. [Medline].

  6. Colombo N, Parma G, Franchi D. An active chemotherapy regimen for advanced ovarian sex cord-stromal tumors. Gynecol Oncol. Feb 1999;72(2):129-30. [Medline].

  7. Colombo N, Parma G, Zanagnolo V, Insinga A. Management of ovarian stromal cell tumors. J Clin Oncol. Jul 10 2007;25(20):2944-51. [Medline].

  8. Cronje HS, Niemand I, Bam RH. Granulosa and theca cell tumors in children: a report of 17 cases and literature review. Obstet Gynecol Surv. Apr 1998;53(4):240-7. [Medline].

  9. Cronje HS, Niemand I, Bam RH. Review of the granulosa-theca cell tumors from the emil Novak ovarian tumor registry. Am J Obstet Gynecol. Feb 1999;180(2 Pt 1):323-7. [Medline].

  10. East N, Alobaid A, Goffin F, Ouallouche K, Gauthier P. Granulosa cell tumour: a recurrence 40 years after initial diagnosis. J Obstet Gynaecol Can. Apr 2005;27(4):363-4. [Medline].

  11. Evans AT 3rd, Gaffey TA, Malkasian GD Jr. Clinicopathologic review of 118 granulosa and 82 theca cell tumors. Obstet Gynecol. Feb 1980;55(2):231-8. [Medline].

  12. Fishman A, Kudelka AP, Tresukosol D. Leuprolide acetate for treating refractory or persistent ovarian granulosa cell tumor. J Reprod Med. Jun 1996;41(6):393-6. [Medline].

  13. Freeman SA, Modesitt SC. Anastrozole therapy in recurrent ovarian adult granulosa cell tumors: a report of 2 cases. Gynecol Oncol. Nov 2006;103(2):755-8. [Medline].

  14. Gershenson DM, Hartmann LC, Young RH. Ovarian Sex Cord-Stromal Tumors. In: Hoskins WJ et al, eds. Principles and Practice of Gynecologic Oncology. 4th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2005:1011-34.

  15. Homesley HD, Bundy BN, Hurteau JA. Bleomycin, etoposide, and cisplatin combination therapy of ovarian granulosa cell tumors and other stromal malignancies: A Gynecologic Oncology Group study. Gynecol Oncol. Feb 1999;72(2):131-7. [Medline].

  16. Jamieson S, Fuller PJ. Management of granulosa cell tumour of the ovary. Curr Opin Oncol. Sep 2008;20(5):560-4. [Medline].

  17. Ko SF, Wan YL, Ng SH. Adult ovarian granulosa cell tumors: spectrum of sonographic and CT findings with pathologic correlation. AJR Am J Roentgenol. May 1999;172(5):1227-33. [Medline].

  18. Korach J, Perri T, Beiner M, Davidzon T, Fridman E, Ben-Baruch G. Promising effect of aromatase inhibitors on recurrent granulosa cell tumors. Int J Gynecol Cancer. Jul 2009;19(5):830-3. [Medline].

  19. La Marca A, Volpe A. Anti-Müllerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool?. Clin Endocrinol (Oxf). Jun 2006;64(6):603-10. [Medline].

  20. Lack EE, Perez-Atayde AR, Murthy AS. Granulosa theca cell tumors in premenarchal girls: a clinical and pathologic study of ten cases. Cancer. Oct 15 1981;48(8):1846-54. [Medline].

  21. Lane AH, Lee MM, Fuller AF Jr. Diagnostic utility of Mullerian inhibiting substance determination in patients with primary and recurrent granulosa cell tumors. Gynecol Oncol. Apr 1999;73(1):51-5. [Medline].

  22. Lappöhn RE, Burger HG, Bouma J, Bangah M, Krans M, de Bruijn HW. Inhibin as a marker for granulosa-cell tumors. N Engl J Med. Sep 21 1989;321(12):790-3. [Medline].

  23. Lee WL, Yuan CC, Lai CR. Hemoperitoneum is an initial presentation of recurrent granulosa cell tumors of the ovary. Jpn J Clin Oncol. Oct 1999;29(10):509-12. [Medline].

  24. Long WQ, Ranchin V, Pautier P. Detection of minimal levels of serum anti-Mullerian hormone during follow-up of patients with ovarian granulosa cell tumor by means of a highly sensitive enzyme-linked immunosorbent assay. J Clin Endocrinol Metab. Feb 2000;85(2):540-4. [Medline].

  25. McEvoy GK, ed. AHFS Drug Information. Bethesda, Md: American Society of Health-System Pharmacists; 2000.

  26. Miller BE, Barron BA, Wan JY. Prognostic factors in adult granulosa cell tumor of the ovary. Cancer. May 15 1997;79(10):1951-5. [Medline].

  27. Mom CH, Engelen MJ, Willemse PH, Gietema JA, ten Hoor KA, de Vries EG. Granulosa cell tumors of the ovary: the clinical value of serum inhibin A and B levels in a large single center cohort. Gynecol Oncol. May 2007;105(2):365-72. [Medline].

  28. Mom CH, Engelen MJ, Willemse PH, Gietema JA, ten Hoor KA, de Vries EG. Granulosa cell tumors of the ovary: the clinical value of serum inhibin A and B levels in a large single center cohort. Gynecol Oncol. May 2007;105(2):365-72. [Medline].

  29. Page R. Chemotherapeutic agents. In: Pazdur R, Hoskins WH, Wagman L, eds. Cancer Management: A Multidisciplinary Approach. 4th ed. Mellville, NY: PRR Incorporated; 2000:971-80.

  30. Pecorelli S, Wagenaar HC, Vergote IB. Cisplatin (P), vinblastine (V) and bleomycin (B) combination chemotherapy in recurrent or advanced granulosa(-theca) cell tumours of the ovary. An EORTC Gynaecological Cancer Cooperative Group Study [published erratum appears in Eur J Cancer 1999 Dec;. Eur J Cancer. Sep 1999;35(9):1331-7. [Medline].

  31. Powell JL, Otis CN. Management of advanced juvenile granulosa cell tumor of the ovary. Gynecol Oncol. Feb 1997;64(2):282-4. [Medline].

  32. Rey RA, Lhomme C, Marcillac I. Antimullerian hormone as a serum marker of granulosa cell tumorsof the ovary: comparative study with serum alpha-inhibin and estradiol. Am J Obstet Gynecol. Mar 1996;174(3):958-65. [Medline].

  33. Robertson DM, Stephenson T, Pruysers E. Characterization of inhibin forms and their measurement by an inhibin alpha-subunit ELISA in serum from postmenopausal women with ovarian cancer. J Clin Endocrinol Metab. Feb 2002;87(2):816-24. [Medline].

  34. Robinson JB, Im DD, Logan L. Extraovarian granulosa cell tumor. Gynecol Oncol. Jul 1999;74(1):123-7. [Medline].

  35. Rubin SC, Sabbatini P, Randall ME. Ovarian Cancer. In: Pazdur R, Hoskins WH, Wagman L, eds. Cancer Management: A Multidisciplinary Approach. 4th ed. Mellville, NY: PRR Incorporated; 2000:409-28.

  36. Segal R, DePetrillo AD, Thomas G. Clinical review of adult granulosa cell tumors of the ovary. Gynecol Oncol. Mar 1995;56(3):338-44. [Medline].

  37. Sehouli J, Drescher FS, Mustea A. Granulosa cell tumor of the ovary: 10 years follow-up data of 65 patients. Anticancer Res. Mar-Apr 2004;24(2C):1223-9. [Medline].

  38. Spencer HW, Mullings AM, Char G. Granulosa-theca cell tumour of the ovaries. A late metastasizing tumour. West Indian Med J. Mar 1999;48(1):33-5. [Medline].

  39. Uygun K, Aydiner A, Saip P. Granulosa cell tumor of the ovary: retrospective analysis of 45 cases. Am J Clin Oncol. Oct 2003;26(5):517-21. [Medline].

  40. Villella J, Herrmann FR, Kaul S, Lele S, Marchetti D, Natiella J. Clinical and pathological predictive factors in women with adult-type granulosa cell tumor of the ovary. Int J Gynecol Pathol. Apr 2007;26(2):154-9. [Medline].

  41. Wolf JK, Mullen J, Eifel PJ. Radiation treatment of advanced or recurrent granulosa cell tumor of the ovary. Gynecol Oncol. Apr 1999;73(1):35-41. [Medline].

  42. Young RH, Dickersin GR, Scully RE. Juvenile granulosa cell tumor of the ovary. A clinicopathological analysis of 125 cases. Am J Surg Pathol. Aug 1984;8(8):575-96. [Medline].

  43. Zanagnolo V, Pasinetti B, Sartori E. Clinical review of 63 cases of sex cord stromal tumors. Eur J Gynaecol Oncol. 2004;25(4):431-8. [Medline].

  44. Zambetti M, Escobedo A, Pilotti S, De Palo G. cis-platinum/vinblastine/bleomycin combination chemotherapy in advanced or recurrent granulosa cell tumors of the ovary. Gynecol Oncol. Mar 1990;36(3):317-20. [Medline].

 
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Microfollicular pattern of an adult granulosa cell tumor at 100X magnification. Inset is characteristic Call-Exner bodies and nuclear grooves (400X). Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.
Less well-differentiated diffuse pattern of adult granulosa cell tumor. Monotonous pattern can be confused with low-grade stromal sarcoma (200X). Inset is high-power magnification demonstrating nuclear grooves and nuclear atypia. Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.
Juvenile granulosa cell tumor. Multiple follicles in various shapes and sizes (200X). Inset shows nuclei that are rounded, hyperchromatic, lacking grooves and showing atypia, and are abnormal mitotic figures (400X). Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.
Gyriform pattern of adult granulosa cell tumor. Undulating single-file rows of granulosa cells (200X). Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.
Theca cell tumor. Typical thecoma with lipid-rich cytoplasm, pale nuclei, and intervening hyaline bands (200X). Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.
Luteinized thecoma. Vacuolated theca cells with an abundant fibromatous stroma (200X). Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.
 
 
 
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