A rare ovarian tumor in childhood: Juvenile granulosa cell tumor revealed by pelvic pain and ovarian torsion

Abstract

We report the case of a 5-year-old girl admitted with a one-month history of pelvic heaviness and acute pelvic pain. Imaging revealed a large heterogeneous pelvic mass involving the genital compartment, with features suggestive of a malignant ovarian tumor. MRI demonstrated a 41 × 57 × 48 mm solid mass with heterogeneous enhancement, restricted diffusion, and areas of necrosis, infiltrating the recto-sigmoid junction. Tumor markers including AFP and beta-hCG were negative, while LDH was mildly elevated. Surgical exploration revealed an encapsulated left ovarian mass with 2 twists of the adnexa, prompting detorsion and partial oophorectomy. Histopathology confirmed a juvenile granulosa cell tumor. Postoperative recovery was uneventful. This case highlights the importance of considering JGCT in the differential diagnosis of ovarian masses in prepubertal girls, the value of advanced imaging for characterization and surgical planning, and the excellent prognosis associated with early surgical management.