Granulosa Cell Tumor: Symptoms, Causes, Diagnosis & Treatment

Written by Medicover Team and Medically Reviewed by Dr Priyanka Mandpe , Gynecologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Granulosa cell tumor is a rare type of ovarian sex cord-stromal tumor that often produces estrogen. It can occur in both adults and children and may cause abnormal uterine bleeding, pelvic pain, or abdominal swelling. Early diagnosis and timely treatment, usually involving surgery, help improve outcomes, reduce the risk of recurrence, and support long-term health.

What Are the Types of Granulosa Cell Tumor?

Granulosa cell tumors are classified based on the age at which they occur and their microscopic appearance.

Adult Granulosa Cell Tumor: The most common type, typically affecting women between 40 and 70 years of age.
Juvenile Granulosa Cell Tumor: A rare type that primarily affects children and young adults.

What Are the Symptoms of Granulosa Cell Tumor?

The clinical presentation of granulosa cell tumours can vary significantly based on the tumour's size, location, and extent of hormonal activity. Commonly reported symptoms include:

Abdominal pain or distension
Menstrual irregularities in premenopausal women
Postmenopausal bleeding
A palpable abdominal mass
Symptoms of estrogen excess, such as breast tenderness or uterine hypertrophy

In some cases, the tumour may be asymptomatic and discovered incidentally during routine imaging or surgical procedures.

What Causes Granulosa Cell Tumor?

The exact cause of granulosa cell tumors is not fully understood. These tumors develop due to abnormal growth of granulosa cells, and certain genetic changes have been linked to their development.

FOXL2 gene mutation (commonly associated with adult granulosa cell tumors)
Abnormal proliferation of granulosa cells
Genetic factors
Rare hereditary influences in selected cases
Unknown (idiopathic) causes

When to See a Doctor for Granulosa Cell Tumor?

Consult a gynecologist or gynecologic oncologist if you experience persistent pelvic pain, abdominal swelling, irregular menstrual bleeding, or bleeding after menopause. Early evaluation can help diagnose ovarian tumors promptly and improve treatment outcomes.

You should see a doctor if you have:

Persistent pelvic or abdominal pain
Abdominal bloating or a noticeable pelvic mass
Abnormal uterine bleeding or heavy menstrual periods
Bleeding after menopause

Get medical help immediately if:

Sudden severe pelvic pain
Rapid abdominal swelling with severe pain
Heavy vaginal bleeding causing dizziness or fainting
Symptoms of ovarian torsion, such as sudden severe pain with nausea and vomiting

These could be signs of serious complications of a granulosa cell tumor that require urgent medical care.

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How is Granulosa Cell Tumors Diagnosed?

Accurate diagnosis of granulosa cell tumours necessitates a combination of clinical evaluation, imaging, and histopathological analysis.

Imaging Techniques

Transvaginal ultrasound often serves as the initial imaging modality, offering detailed visualization of ovarian structures. In cases where further delineation is required, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be employed to evaluate tumour extent and potential metastasis.

Histopathological Examination

Definitive diagnosis hinges on histological examination following surgical biopsy or resection. Characteristic features observed under microscopy include Call-Exner bodies and coffee bean nuclei, which are indicative of granulosa cell tumours.

What Are the Treatment Options for Granulosa Cell Tumors?

The therapeutic approach to granulosa cell tumours is predominantly surgical, supplemented by adjuvant therapies in cases of advanced disease or recurrence.

Surgical Treatment for Granulosa Cell Tumor

Surgical intervention is the cornerstone of treatment, with the primary aim of complete tumour excision. The extent of surgery is tailored to the individual patient based on factors such as age, tumour stage, and desire for fertility preservation. Common procedures include:

Unilateral salpingo-oophorectomy for early-stage disease in young patients
Total abdominal hysterectomy with bilateral salpingo-oophorectomy for postmenopausal women or advanced-stage tumours

Adjuvant Therapies

In instances where complete surgical resection is not feasible, or in cases of recurrence, adjuvant therapies such as chemotherapy or radiotherapy may be considered. However, the efficacy of these treatments in granulosa cell tumours is not well-established, necessitating further clinical research.

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