title: [Granulosa cell tumor of the ovary metastasizing to adrenal gland 13 years after initial diagnosis--diagnostic difficulties and immunohistochemical study].
abstract: We report a case of 49 year old woman with metastasizing granulosa cell tumor of the ovary, adult type, to the right adrenal gland 13 years after initial diagnosis. The tumor was asymptomatic and was detected incidentally by ultrasonography. We performed histopathological analysis of the tumor using immunohistochemical methods. The morphological features, without clinical data, demanded differential diagnosis with a huge group of small cell neoplasms. The immunohistochemical examination: CKAE1 + AE1, CK7, LCA, S-100, chromogranin A, synaptophysin, HMB45, estrogen, progesterone, EMA-negative, vimentine, CD99 and NSE positive, together with clinical data, allowed to make the final diagnosis.
  
  
  CONCLUSIONS
  Patients operated due to granulosa cell tumor need long term follow-up, because of possibility of very late recurrences. In the literature review we did not find any case of isolated granular cell tumor metastasis to the adrenal gland. In the differential diagnosis of such tumors, except of histological features, clinical data play the main role. Usefulness of CD99 antibody in granular cell tumor diagnosis was confirmed. Positive reaction with NSE in tumor cells was detected.
authors.affiliation: Zakładu Anatomii Patologicznej, Akademii Medycznej w Warszawie. wroblewakabogna@o2.pl
authors.forename: Bogna
authors.initials: B
authors.lastname: Ziarkiewicz-Wróblewska
authors.forename: Barbara
authors.initials: B
authors.lastname: Górnicka
authors.forename: Jacek
authors.initials: J
authors.lastname: Pawlak
authors.forename: Piotr
authors.initials: P
authors.lastname: Remiszewski
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Wróblewski
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
authors.forename: Aleksander
authors.initials: A
authors.lastname: Wasiutyński
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D006106:Granulosa Cell Tumor / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed