Background:Ovarian tumors in the girl child are sometimes revealed by the development
of secondary sexual characteristics. The authors report the case of a five-year-old
girl in whom the disease was revealed by early puberty. Case presentation: A
five-year-old girl with an enlarged abdomen for about four months. The onset of
pain and the sensation of a mass prompted the consultation.
The development of secondary sexual characteristics (SSC) noted by the family
had not been mentioned. The patient was classified as pubertal stage 2 according
to the Tanner classification. An abdominal ultrasound and a CT scan showed a large left ovarian mass, an enlarged
uterus for the patient’s age and a normal right ovary. The hormonal workup was
not contributive. The treatment consisted only of a left salpingo-ovarectomy, without
complementary chemotherapy. Anatomic pathological examination of the surgical
specimen concluded to a juvenile tumor of the
granulosa. The evolution was good with a beginning of regression of the HSC
one month after the ovarectomy. Discussion: Granulosa tumors are sometimes
secretory cancers, generally with a low potential for malignancy and therefore a
very good prognosis. Surgery based on total adnexectomy is the first-line treatment.
The large size of the tumor, the presence of ascites and capsular rupture are factors
of poor prognosis, hence the importance of early diagnosis. Conclusion: Routine
comprehensive physical examination should be de rigueur for abdominal masses in
girls, especially in the context of various beliefs that may impede early referral
to care.
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