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Imaging of gynecological disease (3): clinical and ultrasound characteristics of granulosa cell tumors of the ovary

Van Holsbeke, C; Domali, E; Holland, T K; Achten, R; Testa, A C; Valentin, Lil LU ; Jurkovic, D; Moerman, P and Timmerman, D (2008) In Ultrasound in Obstetrics & Gynecology 31(4). p.450-456
Abstract
Objectives To describe the clinical and ultrasound characteristics of granulosa cell tumors (GCTs) of the ovary, and to define the ultrasound appearance of GCTs based on pattern recognition. Methods Databases of four gynecological ultrasound centers were searched to identify patients with histologically proven GCTs who had undergone a standard preoperative ultrasound examination. Results A total of 23 women with confirmed GCT were identified. Twelve (52%) women were postmenopausal, nine (39%) were of fertile age and two (9%) were prepubertal. Clinical symptoms were abdominal distension (7/23, 30%), pain (5/23, 22%) and irregular vaginal bleeding (6/23, 26%). Seven patients (30%) were asymptomatic. Endometrial pathology was found in 54%... (More)
Objectives To describe the clinical and ultrasound characteristics of granulosa cell tumors (GCTs) of the ovary, and to define the ultrasound appearance of GCTs based on pattern recognition. Methods Databases of four gynecological ultrasound centers were searched to identify patients with histologically proven GCTs who had undergone a standard preoperative ultrasound examination. Results A total of 23 women with confirmed GCT were identified. Twelve (52%) women were postmenopausal, nine (39%) were of fertile age and two (9%) were prepubertal. Clinical symptoms were abdominal distension (7/23, 30%), pain (5/23, 22%) and irregular vaginal bleeding (6/23, 26%). Seven patients (30%) were asymptomatic. Endometrial pathology was found in 54% (7/13) of the patients from whom endometrial biopsies were taken. On ultrasound scan 12/23 (52%) masses were multilocular-solid, 9/23 (39%) were purely solid, one mass (4%) was unilocular-solid and one mass was multilocular (4%). Multilocular and multilocular-solid cysts typically contained large numbers of small locules (> 10). The echogenicity of the cyst content was most often mixed (6/16, 38%) or low level (7/16, 44%). Papillary projections were found in only four women (17%). The GCTs were large tumors with a median largest diameter of 102 (range, 37-242) mm and manifested moderate or high color content at color Doppler examination (color score 3 in 13/23 tumors (57%); color score 4 in 8/23 tumors (35%)). Conclusions At ultrasound examination, most GCTs are large multilocular-solid masses with a large number of locules, or solid tumors with heterogeneous echogenicity of the solid tissue. Hemorrhagic components are common and increased vascularity is demonstrated at color/power Doppler ultrasound examination. The hyperestrogenic state that is created by the tumor often causes endometrial pathology with bleeding problems as a typical associated symptom. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ultrasound, rare diseases, granulosa cell tumor, ovarian neoplasm
in
Ultrasound in Obstetrics & Gynecology
volume
31
issue
4
pages
450 - 456
publisher
John Wiley & Sons
external identifiers
  • wos:000255666000016
  • scopus:49849105492
ISSN
1469-0705
DOI
10.1002/uog.5279
language
English
LU publication?
yes
id
5b8f7c8a-1fb1-4bcf-976c-fd4533727b16 (old id 1204501)
date added to LUP
2008-09-17 14:02:21
date last changed
2017-04-30 12:01:32
@article{5b8f7c8a-1fb1-4bcf-976c-fd4533727b16,
  abstract     = {Objectives To describe the clinical and ultrasound characteristics of granulosa cell tumors (GCTs) of the ovary, and to define the ultrasound appearance of GCTs based on pattern recognition. Methods Databases of four gynecological ultrasound centers were searched to identify patients with histologically proven GCTs who had undergone a standard preoperative ultrasound examination. Results A total of 23 women with confirmed GCT were identified. Twelve (52%) women were postmenopausal, nine (39%) were of fertile age and two (9%) were prepubertal. Clinical symptoms were abdominal distension (7/23, 30%), pain (5/23, 22%) and irregular vaginal bleeding (6/23, 26%). Seven patients (30%) were asymptomatic. Endometrial pathology was found in 54% (7/13) of the patients from whom endometrial biopsies were taken. On ultrasound scan 12/23 (52%) masses were multilocular-solid, 9/23 (39%) were purely solid, one mass (4%) was unilocular-solid and one mass was multilocular (4%). Multilocular and multilocular-solid cysts typically contained large numbers of small locules (> 10). The echogenicity of the cyst content was most often mixed (6/16, 38%) or low level (7/16, 44%). Papillary projections were found in only four women (17%). The GCTs were large tumors with a median largest diameter of 102 (range, 37-242) mm and manifested moderate or high color content at color Doppler examination (color score 3 in 13/23 tumors (57%); color score 4 in 8/23 tumors (35%)). Conclusions At ultrasound examination, most GCTs are large multilocular-solid masses with a large number of locules, or solid tumors with heterogeneous echogenicity of the solid tissue. Hemorrhagic components are common and increased vascularity is demonstrated at color/power Doppler ultrasound examination. The hyperestrogenic state that is created by the tumor often causes endometrial pathology with bleeding problems as a typical associated symptom.},
  author       = {Van Holsbeke, C and Domali, E and Holland, T K and Achten, R and Testa, A C and Valentin, Lil and Jurkovic, D and Moerman, P and Timmerman, D},
  issn         = {1469-0705},
  keyword      = {ultrasound,rare diseases,granulosa cell tumor,ovarian neoplasm},
  language     = {eng},
  number       = {4},
  pages        = {450--456},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Imaging of gynecological disease (3): clinical and ultrasound characteristics of granulosa cell tumors of the ovary},
  url          = {http://dx.doi.org/10.1002/uog.5279},
  volume       = {31},
  year         = {2008},
}