MALIGNANT JUVENILE AND ADULT OVARIAN GRANULOSA CELL TUMORS IN PEDIATRIC PATIENTS - REPORT OF TWO CASES
Authors:   Department of Pediatric Surgery and Orthopedics, ", Ataikiru Usiwoma-Okeroghene ,   Victor Babes",   University of Medicine and Pharmacy Timisoara, Romania.,   Department of Pediatric Surgery and Orthopedics "Louis Turcanu" Emergency Children's Hospital Timisoara, Romania., Iacob Emil-Radu ,   Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.,   Department of Pediatric Surgery and Orthopedics "Louis Turcanu" Emergency Children's Hospital Timisoara, Romania., Popoiu Călin-Marius ,   Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.,   Department of Pediatric Surgery and Orthopedics "Louis Turcanu" Emergency Children's Hospital Timisoara, Romania., Fuicu Păun ,   Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.,   Department of Pediatric Surgery and Orthopedics "Louis Turcanu" Emergency Children's Hospital Timisoara, Romania., Heredea Rodica ,   Department of Pathological Anatomy "Louis Turcanu" Emergency Children's Hospital Timisoara, Romania., Miron Ingrith ,   Department of Pediatrics, University of Medicine and Pharmacy Grigore T Popa, Iasi Romania,   Department of Pediatric Hematology and Oncology, St Mary Clinical Emergency Hospital for Children. Iasi, Romania, Boia Eugen Sorin ,   Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.,   Department of Pediatric Surgery and Orthopedics "Louis Turcanu" Emergency Children's Hospital Timisoara, Romania.
Published: January 2021

Juvenile ovarian granulosa cell tumor is a sex chord stromal tumor derived from granulosa cells. It rarely occurs in children. Although it is usually classified as a benign tumor in children due to its good prognosis after surgical intervention, it is a malignant tumor and can be deadly, especially if recurrence occurs. We report two rare cases. The first one is a five-year-old girl with a malignant juvenile ovarian granulosa cell tumor stage 3 FIGO, presenting with abdominal pain in the inferior part of the abdomen and very early pubertal development. On physical examination, she was at stage two puberty. The second case is a 12 years old girl presenting with two periods monthly. An 8.3/5.4cm mass was found at the pelvic region on ultrasound examination. Exploratory laparoscopy with histological examination led to the diagnosis of stage 2A FIGO, combined juvenile and adult ovarian granulosa cell tumor. Conclusion: Precocious puberty accompanying abdominal pain or more than a period in a month is a pointer to juvenile and adult ovarian granulosa cell tumor requiring immediate investigations and patient management. Early diagnosis with the assistance of inhibin test and a FISH test of p53(17p13) aids better management of patients with Juvenile ovarian granulosa cell tumor, preventing tumor recurrence for a favorable outcome. Juvenile and adult ovarian granulosa cell tumors in pediatric female patients can present in different forms but gearing towards menstruation abnormalities.