Granulosa-Theca Cell Tumour
Epidemiology:
- 5% of
all ovarian tumours
- post-menopausal
women in 2/3rds of cases
- but
may be seen at all ages
Common sites:
Gross features:
- unilateral
usually
- variable
size
- solid
or cystic
- yellow
coloration in cut surface if hormonally active (lipid)
- hemorrhage
often
- no
necrosis usually
Histologic
features:
- small,
cuboidal to polygonal cells
- cytoplasm
may be scanty or plenty and densely eosinophilic
(luteinized)
- oval
or angulated nuclei
- haphazardly
oriented
- longitudinal
grooves often (coffee bean)
- not
significantly pleomorphic
- mitotic rate 0-2 / 10HPF usually
- sheets,
anastomosing cords, or strands
- Call-Exner bodies (only present in some cases) (important
clue if present)
- Follicles
/ Rosette-like / glandlike structures filled
with an eosinophilic material
- Stromal component:
- Fibroblasts,
theca cells, and/or lutein cells
- Clusters
or sheets
- Cuboidal to polygonal cells
- Rarely
appearance of high-grade sarcoma
- Conspicuous
foci of old or recent hemorrhage often
- Nuclear
grading has been shown to correlate with prognosis
- Luteinization may be present in some tumours
- More
plump cells with ample cytoplasm
- Sertoli-stromal cell component may be
present (<10% of tumour)
- Juvenile
Granulosa Cell Tumour
(<30y):
- Irregular
or round to oval follicles
- Vary
in both size and shape
- Surrounded
by sheets or nodular aggregates of granulosa
cells
Immunophenotype:
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Marker:
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Sensitivity:
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Specificity:
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Inhibin
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High
|
any sex-cord stromal tumour
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Calretinin
|
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Melan-A
|
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Any sex-cord stromal tumour
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EMA (neg)
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CK7 (neg)
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Molecular features:
Other features:
- may
elaborate large amounts of estrogen
- small
but distinct hazard of malignancy
- tumours composed predominantly
with theca cells are rarely malignant
- indolent course
- recurrences
may occur 10-20y after removal of original tumour