A 12-year-old girl had a 3-pound tumor removed along with her entire left ovary.
She was initially misdiagnosed as having hormonal imbalances from her pituitary gland.
Instead it was a rare type of ovarian cancer that can also affect hormones.
A 12-year-old girl needed her entire left ovary removed due to a tumor that was growing inside it, causing hormonal effects including a disrupted menstrual cycle and lactation.
After getting her first period at age 10, the girl did not have a regular cycle for the next two years. Some menstrual irregularity can be normal, especially in young girls, but the girl started complaining of frequent abdominal pain as well.
The 12-year-old was also leaking a milky discharge from both breasts, which led her doctor to test her hormones. The results confirmed that the girl was not pregnant. However, her prolactin levels — the hormone that triggers milk production — were off the charts.
Doctors initially diagnosed her with a hormonal imbalance originating from the pituitary gland, which is located at the base of the brain. A hyperactive pituitary gland can cause a host of hormonal problems, including irregular periods and unexpected breast milk production.
But because of the girl's worsening abdominal pain, her doctors decided to perform an ultrasound, which revealed a mass in her lower abdomen. In exploratory surgery, they found her left ovary had been completely taken over by a 3-pound tumor. Her case was recently described in the American Journal of Case Reports.
The patient was diagnosed with a rare juvenile form of ovarian cancer
The patient was diagnosed with a rare form of ovarian cancer called a juvenile-type granulosa cell tumor (JGCT), according to the case report. The doctors removed the 3-pound mass along with her left ovary, and she was discharged from the hospital after 4 days.
Granulosa cell tumors account for 5–8% of all ovarian tumors, and only 5% of diagnosed GCTs affect juveniles, according to the case report.
This type of tumor grows from the ovarian tissue that releases the hormones estrogen and inhibin, so it can cause puberty to come early or stop once it's started. Patients as young as 4 years old have developed breasts and pubic hairs due to JGCT, according to a case described in the South Asian Journal of Cancer.
Once the tumor is removed, normal development can resume. In another case described in 2014, a young female patient got her period once and then not again for the next four years. She had a JGCT removed, and her cycle resumed 10 days after surgery.
Researchers warn that doctors should be on the lookout for ovarian tumors in young girls
The authors of the case report wrote that it is uncommon, but not out of the question, for a patient to be diagnosed with JGCT without any signs of early puberty.
Normally, doctors will look to rule out growths on the ovaries and disorders of the pituitary gland if a girl grows breasts or gets her period before age 8, which is considered early by clinical standards. This case shows how subtler symptoms, like the lack of a regular period combined with hormonal imbalances and abdominal pain, can also signal that something is wrong.
The authors of the case study said that medical professionals should consider screening more young girls with a similar constellation of symptoms for ovarian tumors, even if the disease is rare. If it's diagnosed early, JGCT has a high 5-year survival rate of 90-95% — but an undiagnosed tumor can have long-term consequences for a child's development.
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