5 Minute Poster Presentation ARA-NSW 2020 - 42nd Annual NSW Branch Meeting

Paraneoplastic medium-vessel vasculitis of the omentum associated with an ovarian granulosa cell tumour. (#40)

Luke D Williamson 1 , Nicholas Manolios 1 2 , Raghwa Sharma 2 3 4 , David Spencer 1 2
  1. Rheumatology, Westmead Hospital, Westmead, NSW, Australia
  2. University of Sydney, Westmead, NSW, Australia
  3. Department of Tissue Pathology & Diagnostic Oncology, ICPMR, Westmead Hospital, Westmead, NSW, Australia
  4. Western Sydney University, Westmead, NSW, Australia

Paraneoplastic vasculitis is a rare but important cause of systemic vasculitis. The most common cause of paraneoplastic vasculitis is haematological malignancy, with solid tumours only contributing 15% of cases1. Ovarian malignancy has been associated with paraneoplastic syndromes.

Here, we describe the unique case of a 34-year-old woman with a background of endometriosis and polycystic ovarian syndrome, who presented with menorrhagia and dysmenorrhea. She was found to have a 5.6cm left-sided ovarian mass, which was subsequently excised by laparoscopy, with biopsies taken from the omentum at the time of surgery.

The left ovarian mass was found to be histologically consistent with an adult granulosa cell tumour of the ovary. This is an uncommon ovarian tumour, accounting for between 2-5% of all ovarian tumours2. However, it is the most common type of sex cord-stromal tumour of the ovary. Most granulosa cell tumours secrete oestrogen3, which may have impacted on our patient’s initial clinical presentation.

The omental biopsy demonstrated acute vasculitis of the arteries. Histological features were in keeping with a medium-vessel vasculitis of the omentum.

A serological vasculitis screen was normal. A mesenteric angiogram did not demonstrate any evidence of polyarteritis nodosa, and an 18-FDG PET scan was normal.

Ovarian malignancies are associated with paraneoplastic syndromes. However, this is, to our knowledge, the first reported case of a paraneoplastic medium-vessel vasculitis associated with a granulosa cell tumour.


We present this case with an accompanying review of the published literature on paraneoplastic vasculitis.

  1. 1. Kurzrock R, Cohen PR, Markowitz A. (1994) Clinical manifestations of vasculitis in patients with solid tumors. A case report and review of the literature. Arch Intern Med. 154(3), 334-40.
  2. 2. Dridi M, Chraiet N, Batti R, Ayadi M, Mokrani A, Meddeb K, et al. (2018) Granulosa cell tumor of the ovary: a retrospective study of 31 cases and a review of the literature. International Journal of Surgical Oncology. 2018.
  3. 3. Kanthan R, Senger J-L, Kanthan S. (2012) The multifaceted granulosa cell tumours—myths and realities: a review. ISRN obstetrics and gynecology. 2012.