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Updated: Jun 16, 2025
A Coregistered Ultrasound and Photoacoustic Imaging Protocol for the Transvaginal Imaging of Ovarian Lesions
Published on: March 3, 2023
Unusual radiologic imaging in juvenile granulosa cell tumor with precocious puberty: A unilocular cyst
Nurmilia Afriliani1,2, Tri Wulanhandarini1,2
1Department of Radiology, Faculty of Medicine - Universitas Airlangga, Surabaya, Indonesia.
Insights
Juvenile Granulosa Cell Tumors (JGCT) are rare ovarian cancers often presenting with precocious puberty. While imaging can suggest GCTs, histopathology and immunohistochemistry are essential for definitive diagnosis, especially with nonspecific features.
Area of Science:
- Gynecologic Oncology
- Pediatric Oncology
- Pathology
Background:
- Juvenile Granulosa Cell Tumor (JGCT) accounts for 5% of granulosa cell tumors and frequently presents with precocious puberty.
- Granulosa cell tumors (GCTs), including JGCT and adult forms (AGCT), are a subtype of pure sex cord tumors.
Observation:
- A 2-year-old girl presented with suspected ovarian cancer, uterine bleeding, and precocious puberty.
- Initial imaging revealed a cystic pelvic lesion with solid components; diagnosis was confirmed via immunohistochemistry (IHC).
Findings:
- JGCT imaging findings can be nonspecific, making differentiation from other ovarian neoplasms challenging based on imaging alone.
- While GCTs exhibit distinct imaging patterns (e.g., heterogeneity on MRI), these features are not always sufficient for definitive diagnosis.
Implications:
- Diagnostic imaging plays a crucial role in identifying GCTs among ovarian tumors.
- Histopathology and IHC confirmation remain mandatory for accurate diagnosis of JGCT, particularly when radiological features are ambiguous.
Abstract:
Juvenile Granulosa Cell Tumor (JGCT) represents 5% of all granulosa cell cancers. Precocious puberty is a frequent feature of this tumor. A 2-year and 2-month-old girl was referred with a diagnosis of suspected ovarian cancer, dysfunctional uterine bleeding, and precocious puberty. Radiologic examination revealed the following: Abdominal ultrasonography showed a solitary anechoic cystic lesion in the pelvic cavity. MRI confirmed the existence of solid components on its walls. JGCT was then confirmed using immunohistochemistry (IHC) markers. JGCT, along with adult granulosa cell tumors (AGCT) are subgroups of granulosa cell tumors (GCTs), which are part of pure sex cord tumors. The 2 forms share imaging findings due to their comparable gross appearance. GCTs require diagnostic imaging tests to distinguish them from other ovarian tumors. Two ultrasound patterns can be identified GCTs, and MRI showed that GCTs are more heterogeneous than other sex-cord stromal tumors (OSCs). In our case, the imaging characteristics for juvenile granulosa cell tumors were nonspecific and these tumors cannot be reliably distinguished from other ovarian neoplasms based on imaging alone. Although GCTs have imaging characteristics that can help to distinguish them from other tumors, confirmation by histopathology and IHC is still mandatory, especially in cases with nonspecific radiological features.
