ADULT-TYPE GRANULOSA-CELL TUMOR, PRESENTING AS EXTRAOVARIAN METASTASES - ULTRASTRUCTURAL DIAGNOSIS

All granulosa cell tumors have the potential to recur locally or metas tasize, in spite of apparent complete surgical excision. Long-term fol low-up is particularly important in these tumors, since recurrences ma y occur many years after the initial diagnosis. This report highlights the ultrastructural findings that led to the diagnosis of metastatic granulosa cell tumor in two patients presenting with extraovarian mass es. In patient 1 the information about an ovarian granulosa cell tumor removed 9 years before the current admission was obtained only after the metastatic tumor was correctly diagnosed. In patient 2 the ovarian primary was found after abdominal wall involvement by granulosa cell tumor was diagnosed. Thus, in both cases the clinical circumstances we re atypical and electron microscopic examination of the tumors was ess ential to make the diagnosis of granulosa cell tumor with confidence. Based on the features observed in these two extraovarian tumors as wel l as eight other primary ovarian granulosa cell tumors from our files, a consistent ultrastructural profile is identified that can be very u seful for diagnosis.