Two rare cases of ovarian juvenile granulosa cell tumor highlighting the spectrum of clinicopathological presentation in young females: A case series

We report two cases of ovarian juvenile granulosa cell tumors (OJGCTs). Granulosa cell tumors are a rare type of ovarian stromal sex cord tumor with an incidence of 0.4-1.7 per 100,000 women. The juvenile granulosa cell tumor is one subtype. It accounts for only 0.1% of all ovarian tumors and 4-5% of granulosa cell tumors. Two cases of OJGCT are presented. The first case involved a 2-year-old child with vaginal bleeding, breast enlargement, and a pelvic mass. Sex hormone tests revealed low FSH and LH levels with elevated  estradiol (E2). Tumor markers showed elevated LDH and CA-125 levels. MRI confirmed a right ovarian cyst, hydroureter, mild hydronephrosis, and precocious puberty. The tumor measured approximately 5.2 x 10.9 x 11.8 cm on a CT scan. Laparoscopic right oophorectomy was performed. The second case involved a 16-year-old with menometrorrhagia, abdominal pain, and a pelvic mass. MRI confirmed a right ovarian cyst, hydroureter and mild hydronephrosis. The tumor measured ± 8.5 x 12 x 12.5 cm on a CT scan. Right salpingo-oophorectomy was performed. Early detection and intervention are crucial for managing OJGCT. Most patients are young and have a good prognosis, with a 5-year survival rate of 90-100% for stage I tumors.