Metastasis of Adult Granulosa Cell Tumor to Mediastinum, Lung, and Pleura 11 and 25 Years after Initial Diagnosis, Report of Two Cases and Review of the Literature

Author Info

Shaun Boyes Yihong Ma sara Javidiparsijani Vijayalakshmi Ananthanarayanan Xianzhong Ding Xiuzhen Duan

Corresponding Author

Xiuzhen Duan
Department of Pathology, Loyola University Medical Center, Maywood, IL

A B S T R A C T

Ovarian adult granulosa cell tumors are relatively rare low-grade malignant tumor. Metastasis of granulosa cell tumors often happens a long interval after initial surgical resections. This could lead to diagnostic difficulties due to loss of clinical follow up and lack of detailed clinical history. We present 2 cases of metastatic granulosa cell tumor to the lung, pleura, and mediastinum 11 and 25 years respectively after resection of primary tumors. The first case was a 67-year-old woman presented with a large mediastinal mass who underwent surgical resection with a clinical impression of thymoma. The tumor was largely necrotic, and focal viable tumor was composed of epithelioid cells with pale eosinophilic cytoplasm, irregular nuclei, and rare grooved nuclei. No typical Call-Exner body was identified. The histological differential diagnosis was broad, and a metastatic tumor was highly suspected. Additional clinical information was requested; it revealed a history of left ovarian mass with a diagnosis of adult granulosa tumor 11 years ago. The mediastinal tumor was confirmed to be adult granulosa cell tumor by immunohistochemistry. The second case involves a 74-year-old woman who presented with left pleural effusion and a large subpleural lung mass, with biopsy demonstrating classic histological features of adult granulosa cell tumor. She had bilateral salpingo-oophorectomy 25 years ago, so diagnostic details of the ovarian lesion were unavailable. Adult granulosa cell tumor can present as late metastasis at unusual locations. The possibility of metastatic granulosa tumors should always be kept in mind, and clinical history is critical to promote an accurate diagnosis of late onset metastatic granulosa cell tumor.

Article Info

Article Type

Case Report and Review of the Literature

Publication history

Received: Sun 05, May 2019
Accepted: Wed 22, May 2019
Published: Thu 06, Jun 2019

Copyright

© 2023 Xiuzhen Duan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2019.03.04