Juvenile granulosa cell tumor diagnosed in 6-month-old infant with precocious puberty

Abstract

Juvenile granulosa cell tumor is a rare tumor diagnosed in children, which can present with precocious puberty. We have reported a case of a 6-month-old female patient who presented with precocious puberty. Abdominopelvic imaging revealed a large mixed cystic and solid mass, with internal solid enhancement, and restricted diffusion. At surgery, mass was confirmed to arise from the left ovary, and histopathology confirmed juvenile granulosa cell tumor. We provide a literature review of juvenile granulosa cell tumor and discuss imaging characteristics of this diagnosis.

Keywords: Juvenile granulosa cell tumor; Ovarian tumor; Precocious puberty.

Fig. 1

Ultrasound of pelvic mass. (A) Grayscale ultrasound of mixed cystic (white arrow) and solid (white asterisk) pelvic mass. The cystic component contains multiple irregular septations. (B) Ultrasound with Doppler shows internal vascularity of the solid component of the mass (white asterisk).

Fig. 2

Magnetic resonance imaging of abdomen and pelvis. (A) Coronal T2 HASTE image demonstrates a large right sided mixed cystic and solid pelvic mass (white arrows). Additionally noted, rightward deviation of patient's uterus (white asterisk), which is enlarged for age. (B) Axial T1 VIBE fat-sat pre-contrast and (C) Axial T1 VIBE fat-sat post-contrast demonstrates enhancement of internal solid component (white arrows) of the pelvic mass. Axial DWI (D) and ADC map (E) demonstrates restricted diffusion of the internal solid component (black asterisks).

Fig. 3

Gross specimen before (A) and after (B) inking and sectioning.

Fig. 4

Microscopic slides demonstrating predominantly solid appearing mass within the ovary (A) with gelatinous rim of ovarian tissue (B).