Metastasis from a granulosa cell tumour of the ovary presenting in the chest but arising below the diaphragm

Abstract

tTo whom correspondence should be addressed. Eighteen years previously she underwent total abdominal hysterectomy with bilateral salpingooophrectomy for a granulosa cell tumour of the left ovary. At that time there was no evidence of extra-ovarian spread. She remained well until her current illness. Nothing abnormal was found on examination but her erythrocyte sedimentation ratio was raised at 60 mm h -~. Other routine blood tests were normal. Chest X-ray showed a well-defined opacity on the right hemidiaphragm (Plate 1). Computerized tomography (CT) confirmed the presence of a well circumscribed mass confluent with the right hemi-diaphragm but with normal surrounding lung, there were gallstones but no other abnormality in the abdomen or pelvis. Further chest X-ray showed the mass to have increased in size and she was therefore admitted for surgery.