Granulosa cell tumors constitute 2 percent of all ovarian neoplasms. The tumor originates from the ‘rests’ of primitive granulosa cells unused in folliculogenesis. It is the commonest ovarian stromal tumor. It is bilateral only in 2 percent of cases and is a slow growing tumor. The size varies, so also the consistency — may be solid or cystic. Cut section is characteristically yellow or orange due to its lipid content.
MICROSCOPIC APPEARANCE: -
The cells are round or polygonal with granular eosinophilic cytoplasm with ill-defined borders. The tumor cell nuclei are variable in size but they are pale, usually grooved or folded and are called “Coffee bean” nuclei.
Some cells are luteinized containing large polyhedral lipid cells. The cells are arranged in a number of architectural pattern but commonly in folliculoid type. The granulosa cells are arranged in small clusters around a central cavity. These structures are called Call-Exner bodies and are pathognomonic of granulosa cell tumor. The juvenile tumor has less number of Call-Exner bodies and less number of “Coffee bean” nuclei compared to the adult variety. The Metastatic disease and recurrences have been treated with BEP chemotherapeutic regimens. Overall prognosis is good. Life time follow up is essential as recurrence can occur as late as 30 years.
The medicines that can be thought of use are: -
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