Title: Large Ovarian Juvenile Granulosa Cell Tumor in an Adolescent A Case Report and Literature Review
Authors: Benchaaboune Kenza, Belhaj Yassine, Tazi Zineb, Jayi Sofia, Fdili Alaoui Fatimazahrae, Chaara Hekmat, My Abdelilah Melhouf
Volume: 10
Issue: 6
Pages: 69-72
Publication Date: 2026/06/28
Abstract:
Juvenile granulosa cell tumors are rare sex cord stromal ovarian neoplasms, representing approximately five percent of all granulosa cell tumors. They usually occur in premenarchal girls and young women and may present with endocrine manifestations or mass effect. We report the case of a sixteen year old adolescent with a history of rheumatic pancarditis and early menarche, admitted for progressive abdominal distension of one month duration. Imaging showed a large unilateral solid cystic adnexal mass with limited intra abdominal fluid and no secondary lesions. Tumor markers including CA 125, carcinoembryonic antigen, CA 19 9, beta human chorionic gonadotropin and lactate dehydrogenase were normal, whereas alpha fetoprotein was slightly elevated. After preoperative ureteral double J stenting, surgical staging was performed. Exploration found a 25 cm solid cystic tumor arising from the right ovary. The patient underwent right salpingo oophorectomy, omentectomy, peritoneal fluid aspiration and multiple biopsies. Intraoperative rupture led to FIGO stage IC1. Histology confirmed a juvenile granulosa cell tumor confined to the right ovary with negative peritoneal cytology. Close surveillance was chosen and the patient was disease free at six months. This case highlights the diagnostic challenge of a giant adnexal mass in adolescence and the importance of fertility sparing staging surgery, careful pathological confirmation and long term follow up.