article = {SCR-2019-3-104}
title = {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}
journal = {Surgical Case Reports}
year = {2019}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2019.03.04}
url = {https://www.sciencerepository.org/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_SCR-2019-3-104 
author = { Shaun  Boyes, Yihong  Ma ,sara Javidiparsijani,Vijayalakshmi Ananthanarayanan,Xianzhong  Ding,Xiuzhen Duan,}
keywords = {Granulosa Cell , Lung, Pleura }
abstract ={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.}