A rare case of virilizing adult granulosa cell tumor

Abstract

A twenty eight year old lady, married for two years with no issue, presented at Western Regional Hospital Pokhara on 8th July, 1999 with a history of amenorrhea for 1½ years, lump abdomen 1 year, hoarseness of voice for 1 year and signs of hirsutism for the same duration. She was taken up for laparotomy wherein a left ovariectomy with salpingectomy was done and a large cystic ovarian tumor was removed. Post operative period was uneventful and she was advised follow up. The histopathological diagnosis was Adult Granulosa Cell Tumor. What made this case interesting is that most Granulosa Cell Tumors (about 3/4th) are estrogenic or feminizing, but rare examples, including a disproportionate number of large thin walled cystic tumors are androgenic. This was one of those rare virilizing tumors with classical features of infertility, amenorrhea, hoarseness of voice, clitiromegaly, and breast atrophy, but we could not estimate testosterone levels due to lack of facilities available. Key Words: Granulosa Cell Tumor, Virilizing Ovarian Tumors, Sex Cord stromal tumors.