2008 年 20 巻 4 号 p. 233-238
Ovarian granulosa cell tumor (GCT) is a relatively rare neoplasm, with a frequency of 1%-2% of all ovarian neoplasms. Ovarian GCT is categorized as a sex cord stromal tumor and is the most common estrogenproducing ovarian tumor. GCTs are often associated with estrogen-related endometrial changes, ranging from hyperplasia to carcinoma. Herein, we present a case of adult GCT of the ovary with ascites and invasive endometrial carcinoma. A 66-year-old woman presented with a large solid and cystic ovarian tumor. Total hysterectomy and bilateral salpingo-oophorectomy were performed. The cut surface of the tumor had a white-colored solid area and focal necrotic and hemorrhagic areas. Microscopically, a trabecular pattern with edematous stroma, a concomitant microfollicular pattern, and Call-Exner bodies were seen. The pathological diagnosis was adult GCT of the ovary. Immunohistochemical staining was positive for inhibin and vimentin, but negative for cytokeratin (CKAE1 / AE3) . The endometrioid adenocarcinoma (Grade 2) in the uterus showed typical histological findings and immunohistochemical staining. The importance of the present case is that it highlights the fact that GCT are not always low-grade tumors, but can be high-grade malignancies exhibiting invasive growth: the tumor in the present case was large (24.5×18.5×8.0 cm, weighing 2350g), with a considerable amount of ascites and invasive growth of the endometrial carcinoma. That such unusual cases of GCT may occur should be kept in mind when clinical and pathological diagnoses are being made.
