Characterization of Ovarian Granulosa Cell Tumors using Magnetic Resonance Imaging

Main Article Content

Pamela Causa Andrieu Refky Nicola Federico Lipsich Daniel Adri Mariaangeles Gomez Melina Pol Alejandra Wernicke Gabriel Saraniti Carolina Chacon

Abstract

Purpose: To identify the MRI features that aid in the characterization of ovarian granulosa cell tumors.


Materials and methods: 11 MR pelvis of an adult woman with pathology-proven ovarian granulosa cell tumors with surgical pathology.


We evaluated the patient's age, Ca-125, size, laterality, and with MRI features such as indirect signs (i.e., thickened endometrium > 0.9 cm), morphology (cystic, solid-cystic, or solid), subacute hemorrhage, T2 signal (low or intermediate-to-high), restricted diffusion (B values: 0, 50, 1000 sec/mm3/ADC), and dynamic enhancement (intense or similar to myometrium). Also, the presence of ascites, peritoneal implants, or adenopathy.


Results: The final cohort included 11 women with a surgical-pathological diagnosis of granulosa cell tumors. The median age was 52.4 years (range, 17-80). The Ca-125 level was with a median within normal limits. The median size was 9.4 cm. Most cases were unilateral (81.8%) and more frequent on the left (54.5%).


MRI Analysis: 36.4% had endometrial thickening. Ovarian granulosa cell tumors were polymorphous: cystic (54.6%), mixed solid-cystic (9.1%), and solid (36.3%). Most GC had intermediate to high signal on T2 (90.9%), restricted diffusion (81.8%), intense enhancement (81.8%), and 36.4% had intraparenchymal bleeding. 9.1% had associated implants/adenopathy/ ascites at diagnosis.


Conclusion: The MRI features characteristic of ovarian granulosa cell tumors were the polymorphous morphology, an intense enhancement to the myometrium, restricted diffusion, and the presence of intraparenchymal hemorrhage.

Keywords: Granulosa cell tumor of the ovary, magnetic resonance imaging, ovarian neoplasms, Neoplasms, Germ Cell, Embryonal

Article Details

How to Cite
CAUSA ANDRIEU, Pamela et al. Characterization of Ovarian Granulosa Cell Tumors using Magnetic Resonance Imaging. Medical Research Archives, [S.l.], v. 10, n. 6, june 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2813>. Date accessed: 28 mar. 2024. doi: https://doi.org/10.18103/mra.v10i6.2813.
Section
Research Articles

References

1. Colombo N, Parma G, Zanagnolo V, Insinga A. Management of ovarian stromal cell tumors. J Clin Oncol. Jul 10 2007;25(20):2944-51. doi:10.1200/JCO.2007.11.1005
2. Tanaka YO, Saida TS, Minami R, et al. MR findings of ovarian tumors with hormonal activity, emphasizing tumors other than sex cord-stromal tumors. Eur J Rad iol. Jun 2007;62(3):317 -27. doi:10.1016/j.ejrad.2007.02.027
3. Shinagare AB, Meylaerts LJ, Laury AR, Mortele KJ. MRI features of ovarian fibroma and fibrothecoma with histopathologic correlat ion. AJR Am J Roentge nol. Mar 2012;198(3):W296- 303. doi:10.2214/AJR.11.7221
4. Young RH. Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected probl ems. Mod Pat hol. Feb 2005;18 Suppl 2:S81 -98. doi:10.1038/modpathol.3800311
5. Levin G, Zigron R, Haj-Yahya R, Matan LS, Rottenstreich A. Granulosa cell tumor of ovary: A systematic review of recent evide nce. Eur J Obstet Gynecol Reprod Biol. Jun 2018;225:57 -61. doi:10.1016/j.ejogrb.2018.04.002
6. Mancaux A, Grardel Chambenoit E, Gagneur O, Nasreddine A, Gondry J, Merviel P. [Granulosa cell tumor: difficulty of diagnosis and contribution of imaging]. Gynecol Obstet Fertil. Jul-Aug 2013;41(7-8):439-45. Tumeur de la granulosa : difficultes diagnostiques et apport de l'imagerie. doi:10.1016/j.gyobfe.2013.06.005
7. Bazot M. Imagerie de la femme: gynecologie. vol 1. 2017.
8. Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. Nov-Dec 2002;22(6):1305-25. doi:10.1148/rg.226025033
9. Stuart GC, Dawson LM. Update on granulosa cell tumours of the ovary. Curr Opin Obstet Gyne col. Feb 2003;15(1):33-7. doi:10.1097/00001703-200302000-00005
10. Khosla D, Dimri K, Pandey AK, Mahajan R, Trehan R. Ovarian granulosa cell tumor: clinical features, treatment, outcome, and prognostic fact ors. N Am J Med Sci. 2014;6(3):133- 138. doi:10.4103/1947-2714.128475
11. Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin On col. Mar 15 2003;21(6):1180-9. doi:10.1200/jco.2003.10.019
12. Zhang H, Zhang H, Gu S, Zhang Y, Liu X, Zhang G. MR findings of primary ovarian granulosa cell tumor focus on the differentiation with other ovarian sex cord-stromal tum ors. J Ovarian Res. Jun 5 2018;11(1):46. doi:10.1186/s13048-018-0416-x
13. Young RH. Ovarian sex cord-stromal tumors and their mimics. Pathol ogy. Jan 2018;50(1):5-15. doi:10.1016/j.pathol.2017.09.007
14. Kim SH, Kim SH. Granulosa cell tumor of the ovary: common findings and unusual appearances on CT and MR. J Comput Assist Tomogr. Sep-Oct 2002;26(5):756 -61. doi:10.1097/00004728-200209000-00016
15. Babarović E, Franin I, Klarić M, et al. Adult Granulosa Cell Tumors of the Ovary: A Retrospective Study of 36 FIGO Stage I Cases with Emphasis on Prognostic Pathohistological Featu res. Anal Cell Pathol (Am st). 2018;2018:9148124-9148124. doi:10.1155/2018/9148124
16. Jung SE, Rha SE, Lee JM, et al. CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol. Jul 2005;185(1):207-15. doi:10.2214/ajr.185.1.01850207