2020 Volume 59 Issue 3 Pages 141-146
Background : Adult granulosa cell tumors (AGCTs) are a rare low-grade ovarian malignancy. This type of tumor is notorious for its tendency for late recurrence. We herein report on an autopsy case of late recurrent AGCT, in which ascitic and imprint tumor cytologies at autopsy were found to be useful for the definitive diagnosis.
Case : A 75-year-old woman underwent a diagnostic laparoscopy with a clinical diagnosis of probable peritoneal carcinoma. Histologically, the peritoneal nodules revealed a malignancy, not otherwise specified. Ten months later, her history of oophorectomy for AGCT 17 years prior was disclosed. Chemotherapy with paclitaxel was started with a clinical diagnosis of recurrent AGCT, but she died and an autopsy was performed. Ascitic and tumor imprint cytologies showed uniformly oval and naked tumor nuclei with obvious grooves. Call-Exner bodies were absent. A molecular analysis of the tumor revealed a FOXL2 c.402C>G mutation.
Conclusion : This is a case of a late recurrent, molecularly proven AGCT, representing a case of difficulty in the histological diagnosis of AGCT without knowledge of crucial past medical history of AGCT. However, cytomorphologies, particularly nuclear grooves, were retained even in the late recurrent tumor and were of great help in the definitive diagnosis.
