engleski

Metastatic granullosa cell tumor of the spleen: case report

Granulosa cell tumor is a rare and uncommon stromal cell tumor of the ovary, considered to be of low grade malignancy with an indolent clinical course. The 10-year survival is higher than 90%. These tumors are known to manifest metastatic disease years after treatment of the primary tumor. A 64-year-old female with left upper quadrant abdominal pain underwent magnetic resonance, which revealed a tumorous process of the spleen. Splenectomy was performed and the material was referred for histopathologic analysis. Pathologic examination revealed a tumor measuring up to 8 cm, with relatively sharp demarcation. The tumor was grey to brown in color, with necrotic areas and hemorrhage. Microscopically, it was composed of solid sheets, nests and papillary formations lined with atypical cells. Anastomotic vascular-like spaces were also found, lined with relatively uniform atypical cells. Mitotic rate was high (20 mitosis/10HPF). The tumor occupied almost the entire spleen. Extensive histochemical (PAS, Giemsa, Gomori) and immunohistochemical analyses (vimentin, CD31, CD34, FVIII, CD68, CK7, CK20, CD3, CD20, CD30, bcl-6, Ki-67, HMB-45) were done. Tumor cells showed positive reaction to vimentin and proliferative activity defined with Ki-67 was up to 40%. Metastatic tumor was suspected. Retrospective history data revealed a granulosa cell tumor of the ovary 15 years before. Immunohistochemical analysis with inhibin and calretinin was positive. It was diagnosed as a granulosa cell tumor metastatic to the spleen. Metastases of granulosa cell tumor are extremely rare ; they are usually local recurrences or foci of peritoneal spread and occur in 25%-30% of cases. To our knowledge, this is the fourth case of a metastatic granulosa cell tumor in the spleen described in the English literature.

tumor of the spleen

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