Steroid localization in granulosa-theca tumors of the ovary

Eleven granulosa-theca tumors (seven pure granulosa and four with associated theca elements) were examined for the presence of estradiol, progesterone and testosterone using an indirect immunoperoxidase technique on formalin-fixed paraffin embedded tissue. In ten patients the endometrium was studied histologically and significant endometrial hyperplasia consistent with estrogen production by the tumors was found. Estradiol was localized in granulosa cells (nonluteinized) in all 11 cases and in luteinized theca cells in three of the four cases in which theca elements are present. In contrast, progesterone was always detected in luteinized theca cells and in granulosa cells in over one half the cases. Testosterone was also present in granulosa cells in just over half the cases but tended to be only weakly positive. The nonluteinized stromal cells were negative for all steroids. These results are compatible with the concept that in granulosa-theca tumors, both granulosa and theca cells can produce a wide range of steroid hormones but that the predominant steroid present in granulosa cells is estradiol, while progesterone is the predominant steroid in luteinized theca cells.