Androgenic granulosa cell tumors of the ovary. A clinicopathologic analysis of 17 cases and review of the literature.

We reviewed the clinicopathologic features of 17 androgenic granulosa cell tumors. The patients, two of whom were pregnant, ranged from 2 to 58 years of age (average age, 22.5 years). Fourteen of the patients were masculinized as evidenced by various combinations of facial acne, temporal recession of hair, clitorimegaly, deepening of the voice, and a male escutcheon. Five of these patients had amenorrhea; three of the patients demonstrated hirsutism only. The plasma testosterone level is known to have been elevated preoperatively in nine patients, including the three patients with hirsutism. Four prepubertal patients also demonstrated hyperestrinism as manifested by sexual pseudoprecocity. At laparotomy, all of the tumors were stage lai. Five of the tumors formed unilocular and two of the tumors formed multilocular thin-walled cysts that ranged from 23 to 36 cm in diameter. Nine of the remaining tumors were solid, and one tumor was solid and cystic; these tumors averaged 7 cm in diameter. Eleven tumors were granulosa cell tumors of the adult type, and six tumors were juvenile granulosa cell tumors. The only clinically malignant tumor in the series was a unilocular, cystic, adult granulosa cell tumor that recurred 18 months postoperatively and was fatal within four years.