Open AccessAdult granulosa cell tumor: A sinister differential for clomiphene-resistant infertility
Author(s) -
Shalini Gainder,
Japleen Kaur,
Sujata Siwatch,
Nalini Gupta
Publication year - 2018
Publication title -
journal of human reproductive sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.484
H-Index - 31
eISSN - 0974-1208
pISSN - 1998-4766
DOI - 10.4103/jhrs.jhrs_142_17
Subject(s) - medicine , gynecology , granulosa cell , infertility , polycystic ovary , fertility preservation , hyperandrogenism , adnexal mass , laparotomy , ovary , pregnancy , fertility , radiology , insulin , biology , insulin resistance , population , environmental health , genetics
Granulosa cell tumors (GCTs) are rare sex cord-stromal tumors of the ovary. They may present with features of hyperestrogenism. We present a case of a 29-year-old nulliparous female, with infertility and oligomenorrhoea, initially managed with a provisional diagnosis of polycystic ovarian syndrome. She did not respond to multiple cycles of ovulation induction with clomiphene citrate. Later, an ovarian mass was detected, and she was initially planned for laparoscopy. Magnetic resonance imaging pelvis revealed a solid-looking mass in the ovary, with increased vascularity. Fine-needle aspiration cytology from the mass suggested GCT. She underwent staging laparotomy with fertility-preserving surgery. Thereafter, she conceived on first cycle of clomiphene citrate. She delivered twins and is presently 8 months postpartum. Thus, a high index of suspicion for underlying androgen- or estrogen-secreting tumor in cases of clomiphene-resistant infertility with ovarian cysts is advisable.