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26 April 2020 : Case report  Brazil

Torsion of Granulosa Cell Tumor of the Ovary in a Preschool Patient: A Rare Cause of Acute Abdomen

Mistake in diagnosis, Management of emergency care, Rare disease

Ivonete Siviero1ADEF*, Jeferson Tobias da Silva de Oliveira2BC, Danielle Nunes Forny2ABDF, Ivens Baker Méio1EG, Betina Carla Bertrand Simões2BE, Claudia Renata Rezende Penna3BD, Vera Lúcia Antunes Chagas4CD

DOI: 10.12659/AJCR.921689

Am J Case Rep 2020; 21:e921689

Abstract

BACKGROUND: Granulosa cell tumor of the ovary is very rare in childhood; its most common clinical manifestation is isosexual precocious puberty. Clinical presentation as acute abdomen due to pain and ovarian torsion is rare, but a granulosa cell tumor must be suspected in a patient with this acute presentation and signs of early puberty. Adult-type granulosa cell tumor is an even rarer occurrence in children.

CASE REPORT: We report a case of torsion of adult-type granulosa cell tumor of the ovary in a 5-year-old patient with acute abdominal pain and ovarian torsion and highlight the importance of histological diagnosis of this tumor for the therapeutic plan and progression of these patients.

CONCLUSIONS: Precocious puberty, pain, abdominal distension, and an ultrasonography with suspicion of ovarian torsion are warning signs that may indicate the presence of a gonadal stromal tumor in pediatric patients seen at an emergency unit. These patients require long-term follow-up by a pediatrician and gynecologist because of the potential for late recurrence.

Keywords: Abdomen, Acute, Child, Granulosa Cell Tumor, Ovarian Neoplasms, Puberty, Precocious, Torsion Abnormality, Child, Preschool, Salpingo-oophorectomy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923