Juvenile Granulosa cell tumor; a report of two cases for such a rare neoplasm in a pediatric age group

Abstract

Background; Granulosa cell tumor (GCT) is the most common sex cord-stromal tumor that stem from granulosa cells. It comprises only 5% of ovarian tumors of childhood or adolescence. We reported two cases diagnosed with JGCT to highlight the clinical presentation, histopathological characteristics of this rare tumor, to remind the pediatric surgeon and the pediatrician of the necessity to achieve and follow the correct workup. Case 1; A 2.8 years old Female presented to the pediatric surgery clinic with symptoms of vomiting, cramping with lower abdominal pain, enlargement of bilateral breast and abnormal vaginal discharge for 2 months. The diagnosis of juvenile granulosa cell tumor-stage IA was established. Case 2; A 3.4 years old girl was admitted to the Pediatric surgery unit, presented with pallor, abdominal pain, non-bilious vomiting of 2 days duration. Abdominal exploration was decided tumor was totally excised (unilateral salpingo-oophorectomy). The clinical and histopathological studies were compatible with juvenile granulosa cell tumor stage IC. Conclusion; The ovarian JGCT a rare pathology in the pediatric age group. Staging according to the presentation, surgical and histopathologic parameters is an important prognostic factor. Surgery is still the cornerstone in the decision making of the management strategy, while, adjuvant therapy is initiated in the advanced stages.