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Background <p>Juvenile granulosa cell tumors (JGCTs) are rare ovarian tumors with low malignant potential and a very favorable prognosis for patients with stage IA tumors. The majority of JGCTs (~ 97%) occur before age of 30, unlike adult granulosa cell tumors (AGCTs), which are well known for occurrence in older age.</p> Aim of the work <p>This report presents a rare case of late-onset JGCT in a 35-year-old female patient, presenting with multilocular cystic appearance on imaging, a nonspecific feature that cannot reliably distinguish it from other ovarian neoplasms. We aimed to highlight the importance of considering this tumor in the differential diagnosis of multilocular cystic ovarian masses and to discuss its diagnostic challenges with radiologic–pathologic correlation.</p> Case presentation <p>We report a case of a 35-year-old female patient, who presented with a left adnexal cyst incidentally discovered during a routine pelvic ultrasonography for a missed period. Serum tumor markers were within normal range. Pelvic ultrasonography (US) and post-contrast magnetic resonance imaging (MRI) revealed left adnexal multilocular cystic lesion with thickened irregular septae that showed enhancement equal to outer myometrium and restricted diffusion coping with intermediate risk for malignancy according to ovarian-adnexal reporting and data system (O-RADS). The patient underwent laparoscopic cystectomy and the pathology revealed cystic JGCT.</p> Conclusions <p>Late-onset cystic JGCTs are exceedingly rare. Although granulosa cell tumors exhibit distinct imaging characteristics, histopathological confirmation remains essential, particularly in cases with nonspecific laboratory and radiologic features.</p>

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Cystic juvenile granulosa cell tumor with late onset: radiologic and pathologic challenges—a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月9日

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  • Fatmaelzahraa Abdelfattah Denewar,
  • Ahmed E. Eladl,
  • Fatma Mohamed Sherif,
  • Amany Hassan

摘要

Background

Juvenile granulosa cell tumors (JGCTs) are rare ovarian tumors with low malignant potential and a very favorable prognosis for patients with stage IA tumors. The majority of JGCTs (~ 97%) occur before age of 30, unlike adult granulosa cell tumors (AGCTs), which are well known for occurrence in older age.

Aim of the work

This report presents a rare case of late-onset JGCT in a 35-year-old female patient, presenting with multilocular cystic appearance on imaging, a nonspecific feature that cannot reliably distinguish it from other ovarian neoplasms. We aimed to highlight the importance of considering this tumor in the differential diagnosis of multilocular cystic ovarian masses and to discuss its diagnostic challenges with radiologic–pathologic correlation.

Case presentation

We report a case of a 35-year-old female patient, who presented with a left adnexal cyst incidentally discovered during a routine pelvic ultrasonography for a missed period. Serum tumor markers were within normal range. Pelvic ultrasonography (US) and post-contrast magnetic resonance imaging (MRI) revealed left adnexal multilocular cystic lesion with thickened irregular septae that showed enhancement equal to outer myometrium and restricted diffusion coping with intermediate risk for malignancy according to ovarian-adnexal reporting and data system (O-RADS). The patient underwent laparoscopic cystectomy and the pathology revealed cystic JGCT.

Conclusions

Late-onset cystic JGCTs are exceedingly rare. Although granulosa cell tumors exhibit distinct imaging characteristics, histopathological confirmation remains essential, particularly in cases with nonspecific laboratory and radiologic features.