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Image Description

Clinical Presentation: Adult granulosa cell tumor (GCT) can occur at any age but is usually seen in peri- and postmenopausal women (median age 50 years). Occasional cases occur in pre-pubertal patients. It is the most common ovarian tumor with estrogenic manifestations (75% of cases).

The usual presentation is postmenopausal bleeding in older women and menometrorrhagia or amenorrhea in younger women. Unopposed estrogenic stimulation, anovulatory cycles, and the lack of progesterone effect lead to disordered proliferative endometrium and abnormal uterine bleeding.

Endometrial hyperplasia (usually non-atypical) develops in about 50% of patients and carcinoma in 5-10% of cases. Endometrial carcinoma is almost always grade 1 and rarely metastasizes or causes death.

Case History: This image shows atypical endometrial hyperplasia on endometrial curettage in a 45 y/o female who presented with abnormal uterine bleeding. Additional work-up showed a left adnexal mass for which she underwent salpingo-oophorectomy. The diagnosis of adult GCT was confirmed on histology.

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