A granulosa cell tumor secreting estrogen is resected from the left ovary of a 50-year-old woman. Histology shows coffee bean nuclei with nuclear grooves in a microfollicular pattern. This tumor belongs to which WHO classification category, and what is its classic marker?
- A Epithelial ovarian tumor; CA-125
- B Sex cord-stromal tumor; Inhibin B and anti-Mullerian hormone (AMH) ✓
- C Germ cell tumor; AFP and hCG
- D Metastatic tumor; CEA and CA 19-9
Explanation
Granulosa cell tumors (adult type) belong to the sex cord-stromal category per WHO classification. They classically show Call-Exner bodies (microfollicular pattern), nuclear grooves giving a coffee bean appearance, and secrete estrogen causing endometrial hyperplasia or carcinoma. The tumor markers inhibin B and AMH (anti-Mullerian hormone) are highly specific, with inhibin B used for monitoring recurrence. Unlike epithelial tumors, CA-125 is not reliably elevated. Adult granulosa cell tumors have FOXL2 p.C134W somatic mutations in nearly 100% of cases, which is both pathognomonic and a therapeutic target under investigation.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.