Ovarian Granulosa Cell Tumor: A Clinicoradiologic Series with Literature Review

Abstract
Background: Ovarian granulosa cell tumors that originate from the sex cord-stromal cells represent 2% to 5% of all ovarian cancers. These tumors constitute two subgroups according to their clinical and histopathological features: juvenile granulosa cell tumors (JGCT) and adult granulosa cell tumors (AGCT). Granulosa cell tumor (GCT) is considered to be a low-grade malignancy with a favorable prognosis. Methods: This case series includes four patients who admitted to our university hospital and had an MRI examination within 5 years. Results: The histopathological subtype of granulosa tumor was the adult type in 3 patients and juvenile type in 1 patient. Even though its extremely rare, bone metastases were present in one of our patients. Liver metastases were also detected in one patient. The MRI examination of tumors revealed a heterogeneous solid mass that contained cystic components in 3 patients. In one of our patients, the tumor had a multiseptated cystic feature, and all of the tumors were ovoid or round with smooth margins. T1 signal hyperintensity, not suppressed on fat saturation sequences, observed in our 3 patients, which represents its hemorrhagic content. Conclusion: Even though granulosa cell tumor shows a wide spectrum in terms of tumor appearance, some common findings have been shown and especially a hemorrhagic content could be a clue for us. The tumor is known to have a good prognosis, but it may have an unpredictable clinical course, so close follow-up has a great importance.