Diagnosis: Adult Granulosa Cell Tumor
• Adult granulosa cell tumors are well known to secrete estrogen; this is important clinically because increased unopposed estrogen can lead to endometrial hyperplasia or carcinoma.
• Adult granulosa cell tumors display various patterns, including diffuse, microfollicular, insular, and trabecular patterns. Commonly, a mixture of patterns may be demonstrated in a single patient, illustrating the importance of ample sampling of these neoplasms.
• Grossly, adult granulosa cell tumors can have a tan-to-yellow appearance. Grossly yellow tumors are due to increased steroid production.
• Granulosa cell tumors are strongly and diffusely positive for inhibin, separating these tumors from many carcinomas, which are often inhibin negative.
• Stage remains the most important prognostic factor in granulosa cell tumors. Other prognostic factors include tumor size, age of the patient, presence or absence of tumor rupture, and mitotic activity.
