Which ovarian tumor is described as arising from the wall of a follicle and is the most common primary ovarian neoplasm?

• A. Cystic teratoma, dermoid
• B. Serous cystadenoma
• C. Mucinous cystadenoma
• D. Granulosa cell tumor

Answer: (A)

A tumor arising from the wall of a ovarian follicle points to granulosa cell tumor. Granulosa cells line the follicle, and when they become neoplastic, they form a granulosa cell tumor, a sex cord–stromal tumor. These tumors are the most common neoplasms of the sex cord–stromal family and can produce estrogen, which may lead to clinical signs like abnormal uterine bleeding in adults.

Note that the statement about being the most common primary ovarian neoplasm isn’t accurate for granulosa cell tumors overall; the most common ovarian neoplasms are epithelial tumors such as serous cystadenomas. Dermoid (mature cystic teratoma) is a common ovarian tumor but does not arise from the follicle wall. The key clue here is the origin from the follicle wall, which specifically points to granulosa cell tumor.