This page is dedicated to organizing various examples of standardized exam questions whose answer is a granulosa cell tumor of the ovary. While this may seem a odd practice, it is useful to see multiple examples of how granulosa cell tumor of the ovary will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 50 year old woman, G2P2, comes to the clinic due to 11 months of irregular vaginal bleeding. Her last menstrual period was 4 years ago. She has a past medical history of hypothyroidism that is controlled with daily levothyroxine. Ultrasound is conducted and reveals a thickened endometrium and a solid right sided adnexal mass. An endometrial biopsy is abnormal, and the patient is told that she requires surgery. Intraoperatively, the ovarian was is yellow and firm. Pathology from he mass reports small cuboidal cells that are present in sheets. There is also a gland-like structure present that contains acidophilic material. The cells are arranged in a micro follicular pattern around this eosinophilic center. What diagnosis is most consistent with this presentation?
A 61 year old woman comes the clinic because she has experienced two episodes of vaignal bleeding in the past few weeks. Menopause occurred 10 years ago. Her past medical history is notable for hypertension that is treated with lisinopril, and type 2 diabetes mellitus that is treated with insulin. She has never had an abnormal Pap smear and her BMI is 24 kg/m². A physical exam reveals an unremarkable cervix and uterus with the exception of blood at the cervical os. A 6 x 7 cm ovarian mass is palpated. A pelvic ultrasound is conducted and confirms the presence of this ovarian mass. An endometrial biopsy shows atypical complex hyperplasia. What is the likely diagnosis in this patient?
A 49 year old G3P3 woman presents with a several month history of abdominal bloating. She explains that her symptoms have gotten progressively worse. She has had regular menses her entire life, but recently notes her bleeding to be heavier had has been occurring twice each month. Her past medical history is unremarkable and she denies drinking or smoking. On examination, she is 5 feet 6 inches tall and weighs 135 pounds. Her abdominal exam is notable for some mild distension, but no masses are palpated. Her pelvic examination reveals a normal appearing cervix, a non-enlarged uterus, and a 9 cm mobile, non-tender right adnexal mass. An endometrial biopsy is collected and reveals complex endometrial hyperplasia without atypia. What is the most likely explanation for this patient’s presentation?
A 7 year old girl is brought to the clinic because she has been experiencing breast development. Her mother explains that she has gained 4 inches in height over the past 4 months, and now also has pubic hair. Her mother is concerned because she feels as though her daughter looks much older then the other children at school. The patient’s past medical history is notable for a diagnosis of atopic dermatitis for which the patient uses topical corticosteroids intermittently. The patient takes no other medications, does not have any known allergies, and her immunizations are up to date. The patient’s weight is at the 65th percentile, and her height is in the 99th percentile. A physical exam reveals a pelvic mass and also white, odorless vaginal discharge. A pelvic ultrasound is order, and confirms a right ovarian mass. What is a likely diagnosis in this patient?
Page Updated: 10.29.2016