granulosa cell tumor
Meaning of granulosa cell tumor: An ovarian tumor arising from the cells that nurse a developing egg, and one that usually keeps making estrogen.
Definition of granulosa cell tumor
A granulosa cell tumor is a growth of the ovary arising from granulosa cells, the cells that surround and nourish a developing egg. It belongs to the sex cord stromal group rather than to the common surface epithelial ovarian cancers. Most continue to produce estrogen, and the effects of that hormone frequently draw attention to the tumor before it has grown large.
What do granulosa cells normally do?
Inside the ovary, each egg sits within a follicle, wrapped in a layer of granulosa cells. Those cells feed the egg, respond to the pituitary signal that drives a follicle to mature, and convert precursor hormones into estrogen. After ovulation they reorganize into the corpus luteum and switch to producing progesterone. A tumor formed from them tends to keep the hormone-making habit.
What are the two types?
| Adult type | Juvenile type | |
|---|---|---|
| Who it affects | Mostly around and after menopause | Children and young women |
| Pace | Slow, recurrence often very late | Faster, but recurrence usually early if at all |
| Typical genetic change | A mutation in the FOXL2 gene | Different changes; FOXL2 usually normal |
Why does the hormone matter?
Estrogen made outside the normal cycle produces effects that depend on age. In a young child it causes signs of puberty long before the expected time, including breast development and vaginal bleeding. In adult years it produces heavy, irregular or absent periods. After menopause it causes bleeding that should not occur at all, and it thickens the lining of the womb. That thickening is important in its own right, since prolonged estrogen without the balancing effect of progesterone can lead to overgrowth of the lining and to cancer of the womb, which is looked for alongside the ovarian tumor.
How does it behave over time?
These tumors are usually found while still confined to one ovary, and most are low grade and slow. What sets the adult type apart is the timing of recurrence, which can come a decade or two after apparently successful surgery, so follow-up runs for many years rather than the usual five. Blood levels of inhibin and anti-Mullerian hormone, both made by granulosa cells, are used to track the disease. A Sertoli-Leydig cell tumor is the counterpart that makes male hormones instead and causes the opposite pattern of change.
Used in a sentence
Histology confirmed an adult granulosa cell tumor confined to the right ovary.
Good to know
Recurrence of the adult type can occur many years after surgery, and the estrogen these tumors produce means the lining of the womb is assessed as well.
Word origin
Where “granulosa cell tumor” comes from
Granulosa derives from the Latin granulum, a small grain, describing the appearance of the cells packed around a developing egg.