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Adult granulosa cell tumor presenting with massive ascites, elevated CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

Tak JY, Chong GO, Park JY, Lee SJ, Lee YH, Hong DG - Obstet Gynecol Sci (2015)

Bottom Line: Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature.An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer.In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature. An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer. AGCT has low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography due to its low metabolic activity. In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

No MeSH data available.


Related in: MedlinePlus

(A) Gross findings of the left ovarian tumor. (B, C) Histopathological features of the tumor cells (hematoxylin and eosin stain; B, ×100; C, ×400). (D-F) Immunohistochemical staining of the tumor cells (D, calretinin; E, alpha-inhibin; F, cytokeratin 7; D-F, ×200).
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Figure 2: (A) Gross findings of the left ovarian tumor. (B, C) Histopathological features of the tumor cells (hematoxylin and eosin stain; B, ×100; C, ×400). (D-F) Immunohistochemical staining of the tumor cells (D, calretinin; E, alpha-inhibin; F, cytokeratin 7; D-F, ×200).

Mentions: The final histopathology results revealed an AGCT. Grossly, the tumor had a yellow to tan color, with a uniloculated cyst containing solid components with mural thickening or trabeculated intraluminal masses (Fig. 2A). Microscopically, the tumor showed mixed growth patterns, including diffuse (70%) and anastomosing trabecular (20%) patterns. It also displayed microfollicular (5%) and gyriform (5%) features (Fig. 2B), although these were less common. Tumor cells showed relatively uniform, oval, angular, and often grooved nuclei with scant cytoplasm (Fig. 2C). Some foci showing a microfollicular pattern with eosinophilic and hyalinized components were identified as Call-Exner bodies. The mitotic activity was 1 to 2 mitotic figures/10 high power fields. Tumor cell necrosis was not observed. The ipsilateral peritubal soft tissue adherent to the ovary was infiltrated by the tumor cells. However, the contralateral ovary and fallopian tube, uterus and omentum, as well as multiple pelvic soft tissues and 35 pelvic lymph nodes all tested negative for malignancy. Additionally, intraoperative cytological examination of the ascites showed no evidence of malignant cells. Immunohistochemical results indicated that the tumor was diffusely positive for calretinin (Fig. 2D), focally and weakly positive for alpha-inhibin (Fig. 2E), and negative for cytokeratin 7 (Fig. 2F). This immunonegativity for cytokeratin 7 can exclude the possibility of undifferentiated primary or metastatic carcinoma.


Adult granulosa cell tumor presenting with massive ascites, elevated CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

Tak JY, Chong GO, Park JY, Lee SJ, Lee YH, Hong DG - Obstet Gynecol Sci (2015)

(A) Gross findings of the left ovarian tumor. (B, C) Histopathological features of the tumor cells (hematoxylin and eosin stain; B, ×100; C, ×400). (D-F) Immunohistochemical staining of the tumor cells (D, calretinin; E, alpha-inhibin; F, cytokeratin 7; D-F, ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588851&req=5

Figure 2: (A) Gross findings of the left ovarian tumor. (B, C) Histopathological features of the tumor cells (hematoxylin and eosin stain; B, ×100; C, ×400). (D-F) Immunohistochemical staining of the tumor cells (D, calretinin; E, alpha-inhibin; F, cytokeratin 7; D-F, ×200).
Mentions: The final histopathology results revealed an AGCT. Grossly, the tumor had a yellow to tan color, with a uniloculated cyst containing solid components with mural thickening or trabeculated intraluminal masses (Fig. 2A). Microscopically, the tumor showed mixed growth patterns, including diffuse (70%) and anastomosing trabecular (20%) patterns. It also displayed microfollicular (5%) and gyriform (5%) features (Fig. 2B), although these were less common. Tumor cells showed relatively uniform, oval, angular, and often grooved nuclei with scant cytoplasm (Fig. 2C). Some foci showing a microfollicular pattern with eosinophilic and hyalinized components were identified as Call-Exner bodies. The mitotic activity was 1 to 2 mitotic figures/10 high power fields. Tumor cell necrosis was not observed. The ipsilateral peritubal soft tissue adherent to the ovary was infiltrated by the tumor cells. However, the contralateral ovary and fallopian tube, uterus and omentum, as well as multiple pelvic soft tissues and 35 pelvic lymph nodes all tested negative for malignancy. Additionally, intraoperative cytological examination of the ascites showed no evidence of malignant cells. Immunohistochemical results indicated that the tumor was diffusely positive for calretinin (Fig. 2D), focally and weakly positive for alpha-inhibin (Fig. 2E), and negative for cytokeratin 7 (Fig. 2F). This immunonegativity for cytokeratin 7 can exclude the possibility of undifferentiated primary or metastatic carcinoma.

Bottom Line: Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature.An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer.In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature. An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer. AGCT has low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography due to its low metabolic activity. In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

No MeSH data available.


Related in: MedlinePlus