Granulosa Cell Tumor

Granulosa Cell Tumor

Steven S. Shen, MD, PhD

Mahul B. Amin, MD

Jae Y. Ro, MD, PhD

A GCT shows a well-circumscribed, homogeneous, tan-white nodule. The tumor is small and like many sex cord stromal tumors, does not extensively involve the testis. Hemorrhage and necrosis are lacking.

A GCT shows typical Call-Exner bodies image characterized by central eosinophilic material and palisading tumor cells resulting in a rosette appearance. The tumor cells have scant cytoplasm.



  • Granulosa cell tumor (GCT)


  • Sex cord stromal tumor of testis occurring in adults and resembling its counterpart of ovarian granulosa cell tumor



  • Incidence

    • Extremely rare; fewer than 2 dozen cases have been documented

  • Age

    • Range: 16-76 years (mean: 44 years)

    • Juvenile GCT occurs in 1st few months of life


  • Painless testicular mass

  • May be associated with gynecomastia (about 25%)


  • Surgical approaches

    • Curable by surgical resection in most cases

    • May be managed by partial orchiectomy


  • Most have indolent clinical course but have malignant potential

  • Metastasis has been reported (20% of cases)

  • Long-term follow-up is recommended for all patients


General Features

  • Well-circumscribed, sometimes encapsulated, homogeneous yellow to gray firm mass

  • ± small cysts

  • Hemorrhage or necrosis is unusual


  • Range: 2-10 cm (average: 5 cm)


Histologic Features

  • Growth patterns: Microfollicular (most common), solid, trabecular, insular, macrofollicular, gyriform, or cystic

  • Presence of Call-Exner bodies (eosinophilic material surrounded by palisading granulosa cells)

  • Relatively uniform round or ovoid cells (carrot-shaped) with scant, lightly staining cytoplasm

  • Elongated or angular nuclei with grooves (coffee bean-shaped) with 1 or 2 peripherally located nucleoli

  • Focal cytologic atypia and rare mitoses; mitoses may be high with varying degree of nuclear pleomorphism

  • May intermingle with seminiferous tubules and infiltrate tunica albuginea

  • Some show focal theca cell differentiation or have smooth muscle or osteoid differentiation

  • Rare hemorrhage, necrosis, or angiolymphatic invasion

  • Features seen more often in tumors with malignant outcome: Large size (> 7 cm), frequent mitoses (> 4/10 HPFs), hemorrhage, necrosis, lymphovascular invasion

Predominant Pattern/Injury Type

  • Solid and microfollicular

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Granulosa Cell Tumor
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