Juvenile testicular granulosa cell tumor in the neonatal period: Diagnosis and management of two clinical cases

Abstract

Introduction: Juvenile granulosa cell tumor of the testis is a rare neoplasm of the sex cord–stromal tissue, representing less than 5% of pediatric testicular tumors. It is characterized by a benign clinical course and typically presents as a painless scrotal mass in newborns or infants. Objective: To describe two clinical cases of juvenile granulosa cell tumor of the testis in infants, highlighting their clinical features, imaging findings, histopathological confirmation, and therapeutic management, with emphasis on differential diagnosis. Methodology: Report of two clinical cases following CARE guidelines, including clinical, imaging, and histopathological analysis, after obtaining informed consent from both legal guardians. Development: Two infants with heterogeneous solid-cystic testicular lesions identified on ultrasound are described. One had tumor markers within the normal range, while the other showed elevated alpha-fetoprotein levels. Both were managed with radical orchiectomy and had favorable outcomes. Histopathological and immunohistochemical analysis confirmed the diagnosis of juvenile granulosa cell tumor of the testis. Discussion: Juvenile granulosa cell tumor of the testis should be considered in the differential diagnosis of testicular masses in infants, especially in comparison with yolk sac tumor. Age and contextual interpretation of clinical and histopathological findings are essential for diagnosis. Although radical orchiectomy remains the standard treatment, conservative approaches and emerging therapies exist in selected cases. This report reinforces the importance of its recognition and proper clinicopathological correlation.