WBR0725
| Author | [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Genitourinary, SubCategory::Oncology |
| Prompt | [[Prompt::An 8-year-old girl is brought by her mother to the physician's office for progressive abdominal swelling, weight loss, and low grade fever. On physical examination, the physician notes bilateral non-tender enlargement of the breasts with induced galactorrhea. Abdominal inspection reveals moderate distention. Deep palpation of the abdomen is remarkable for a multi-lobulated mass at the left lower quadrant. Following appropriate work-up, a large left ovarian mass is detected; and the patient is scheduled for resection. Grossly, the mass is a solid white-gray tumor with multilocular cystic appearance. Microscopic analysis shows Call-Exner bodies separated by thin fibrous septae. What is the most likely diagnosis of this patient's condition?]] |
| Answer A | AnswerA::Granulosa cell tumor |
| Answer A Explanation | AnswerAExp::Granulosa cell tumor is an ovarian non-germ cell tumor that often secretes estrogen. It has a grey-white multilocular appearance on gross pathology and characteristic Call-Exner bodies on microscopy. |
| Answer B | AnswerB::Teratoma |
| Answer B Explanation | AnswerBExp::Teratoma is the most common ovarian germ cell tumor. It is characterized by the presence of several germ layers. Call-Exner bodies are not typically observed in teratomas. |
| Answer C | AnswerC::Brenner tumor |
| Answer C Explanation | AnswerCExp::Brenner tumor is a benign ovarian non-germ cell tumor characterized by the presence of a pale yellow unilateral tumor on gross pathology and "coffee bean" nuclei on microscopy. |
| Answer D | AnswerD::Yolk sac tumor |
| Answer D Explanation | AnswerDExp::Yolk sac tumor is a malignant ovarian germ cell tumor. It is characterized by the presence of yellow friable mass on gross pathology and the presence of Schiller-Duval bodies that look like kidney glomeruli on microscopy. |
| Answer E | AnswerE::Dysgerminoma |
| Answer E Explanation | AnswerEExp::Dysgerminoma is a malignant ovarian germ cell cancer associated with Turner syndrome. Call-Exner bodies are not typically found in dysgerminoma. |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::Granulosa cell tumor is a rare estrogen-secreting sex cord stroma tumor that may present among young children with a clinical presentation of precious puberty, or among adult women of reproductive age with a typical clinical presentation of abnormal uterine bleeding (AUB), predisposition of endometrial hyperplasia, and endometrial cancer.
Grossly, granulosa cell tumor appears as a multilocular mass in the ovaries. Microscopically, Call-Exner bodies, which are follicular structures containing acidophilic material, are characteristic. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Granulosa, WBRKeyword::Cell, WBRKeyword::Tumor, WBRKeyword::Ovarian, WBRKeyword::Malignant, WBRKeyword::Call-exner, WBRKeyword::Call-Exner, WBRKeyword::Call, WBRKeyword::Exner, WBRKeyword::Precocious, WBRKeyword::Puberty, WBRKeyword::Endometrial cancer, WBRKeyword::Hyperplasia, WBRKeyword::Breast, WBRKeyword::Enlargement, WBRKeyword::Estrogen |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |