A 3-year-old girl is brought in for breast development, pubic hair, and a growth spurt over 6 months. Abdominal examination reveals a 9 cm smooth solid left adnexal mass. Excision biopsy shows follicles of varying size lined by plump granulosa cells lacking the coffee-bean nuclear grooves seen in the adult form. Which subtype is this?

• A Adult granulosa cell tumour
• B Gonadoblastoma
• C Thecoma
• D Juvenile granulosa cell tumour ✓

Explanation

Juvenile granulosa cell tumour occurs almost exclusively in prepubertal girls and causes isosexual precocious puberty through oestrogen secretion. Histologically it forms follicle-like spaces with basophilic secretions, and the cells lack the nuclear grooves typical of the adult type, which instead shows Call-Exner bodies and affects peri- and postmenopausal women. Thecoma rarely causes precocity and gonadoblastoma arises in dysgenetic gonads.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.