Ultrasound feature discordance in a bilateral juvenile ovarian granulosa cell tumor: A case report

BackgroundAs a rare ovarian stromal tumor, the juvenile ovarian granulosa cell tumor (JGCT) is mainly seen in premenstrual and young women. It associates with high malignancy and recurrence rate, and early diagnosis and treatment could improve prognosis. Most cases are unilateral solid-cystic or solid masses, while unilocular cystic masses are rarely seen. As cystic ovarian tumors are often misdiagnosed as benign cystic lesions or functional cysts, cystic JGCT should not be overlooked.Case presentationWe report this special case of a 10-year-old female patient. It’s the first reported JGCT with completely inconsistent bilateral imaging manifestations, including an extremely rare unilocular cystic JGCT. A large solid-cystic JGCT appeared in her left ovary, and left adnexal resection was performed. A unilocular cyst occurred in the right ovary two years later. It was with a regular shape and smooth inner wall, mimicking a benign cyst. Since the patient was young and had the desire to preserve the right ovary, follow-up was initially recommended. However, the cyst size increased rapidly and exploratory laparotomy was finally performed. Pathology showed a unilocular cystic JGCT.ConclusionsAs cystic masses in young patients are easily misdiagnosed as benign or physiologic lesions, this case emphasizes the importance of postoperative follow-up for JGCTs. Exploratory laparotomy of persistent cystic lesions should be considered when necessary.