PDF(Pubmed)
Abstract：
BACKGROUND: Although female victims of sexual child abuse present with symptoms such as local pain and vaginal bleeding, however, before any definitive diagnosis a comprehensive physical examination along with a detailed history related to vaginal bleeding should be taken from the patient. Undoubtedly, we must not forget that only one of the causes of vaginal bleeding is rape. Therefore, before making a final diagnosis, other causes of this symptom must be carefully examined.
METHODS: The patient was a 6-years-old female who was hospitalized for notable generalized abdominal distention, acute lower abdomen pain associated with nausea and mild fever lasting 5 days progressively worsening, thelarche and vaginal bleeding. Ultrasound examination showed that multilocular-solid masses located in right side of abdomen which led to surgery and mass excision. Histopathology diagnosis was a juvenile granulosa cell tumor of the ovary.
CONCLUSIONS: Among the various causes of peripheral premature puberty, granulosa cell tumor (GCT) is rare but very important. Since in the two age groups - prepuberty and menopause - we don\'t expect to see vaginal bleeding, the occurrence of this disorder especially in association with breast enlargement in prepubertal group, need to appropriate imaging including pelvic ultrasound and bone age determination also laboratory data such as level of sex hormones and tumor markers to avoid misdiagnosis.
CONCLUSIONS: We report the case of a granulosa cell tumor patient with vaginal bleeding that a complete history and examination provides the right path to a diagnosis.
METHODS: The patient was a 6-years-old female who was hospitalized for notable generalized abdominal distention, acute lower abdomen pain associated with nausea and mild fever lasting 5 days progressively worsening, thelarche and vaginal bleeding. Ultrasound examination showed that multilocular-solid masses located in right side of abdomen which led to surgery and mass excision. Histopathology diagnosis was a juvenile granulosa cell tumor of the ovary.
CONCLUSIONS: Among the various causes of peripheral premature puberty, granulosa cell tumor (GCT) is rare but very important. Since in the two age groups - prepuberty and menopause - we don\'t expect to see vaginal bleeding, the occurrence of this disorder especially in association with breast enlargement in prepubertal group, need to appropriate imaging including pelvic ultrasound and bone age determination also laboratory data such as level of sex hormones and tumor markers to avoid misdiagnosis.
CONCLUSIONS: We report the case of a granulosa cell tumor patient with vaginal bleeding that a complete history and examination provides the right path to a diagnosis.
摘要：
背景：尽管性虐待儿童的女性受害者出现局部疼痛和阴道出血等症状，然而,在做出明确诊断之前，应对患者进行全面的体格检查以及与阴道出血相关的详细病史。毫无疑问,我们不能忘记，阴道出血的唯一原因之一就是强奸。因此,在做出最终诊断之前，这种症状的其他原因必须仔细检查。
方法：患者为一名6岁女性，因明显的全身性腹胀住院，伴有恶心和轻度发烧的急性下腹部疼痛持续5天，逐渐恶化，出血和阴道出血。超声检查显示多房性实性肿块位于腹部右侧，导致手术和肿块切除。组织病理学诊断为卵巢幼年颗粒细胞瘤。
结论：在周围性早熟的各种原因中，颗粒细胞瘤（GCT）很少见，但非常重要。因为在两个年龄组-青春期前和更年期-我们不希望看到阴道出血，这种疾病的发生，特别是与青春期前组的乳房增大有关，需要适当的影像学检查包括骨盆超声和骨龄测定以及性激素水平和肿瘤标志物等实验室数据，以避免误诊。
结论：我们报告了一例伴有阴道出血的颗粒细胞瘤患者，完整的病史和检查为诊断提供了正确的途径。
方法：患者为一名6岁女性，因明显的全身性腹胀住院，伴有恶心和轻度发烧的急性下腹部疼痛持续5天，逐渐恶化，出血和阴道出血。超声检查显示多房性实性肿块位于腹部右侧，导致手术和肿块切除。组织病理学诊断为卵巢幼年颗粒细胞瘤。
结论：在周围性早熟的各种原因中，颗粒细胞瘤（GCT）很少见，但非常重要。因为在两个年龄组-青春期前和更年期-我们不希望看到阴道出血，这种疾病的发生，特别是与青春期前组的乳房增大有关，需要适当的影像学检查包括骨盆超声和骨龄测定以及性激素水平和肿瘤标志物等实验室数据，以避免误诊。
结论：我们报告了一例伴有阴道出血的颗粒细胞瘤患者，完整的病史和检查为诊断提供了正确的途径。
