______ cell tumors are hormonal neoplasms and are likely to cause an increase in estrogen.

• A. Granulosa cell tumor
• B. Thecoma
• C. Dysgerminoma
• D. Theca lutein cysts

Answer: (A)

Estrogen production by ovarian tumors is a hallmark of sex cord-stromal tumors, with the granulosa cell tumor being the classic estrogen-secreting neoplasm. These tumors arise from granulosa cells, which normally generate estrogen; when a tumor consists of these cells, estrogen is produced autonomously. The result is signs of estrogen excess, such as endometrial proliferation and abnormal uterine bleeding in adults, or early puberty in children. On ultrasound, granulosa cell tumors are typically solid and may be vascular, sometimes with small cystic areas from degeneration. The other options don’t fit as well: dysgerminoma is a germ cell tumor not known for hormone production; theca-lutein cysts are functional cysts related to high hCG and are not neoplastic estrogen producers; thecoma can produce estrogen but is less classically associated with marked estrogen excess compared to granulosa cell tumors.