Figure 6b. Juvenile GCT in a 2-year-old girl who showed development of the breasts, the appearance of pubic hair, and atypical genital bleeding. (a) Sagittal T2-weighted MR image demonstrates a large solid mass with high signal intensity (arrows) and an enlarged uterus with thick endometrium (arrowheads). Ascites is also seen. (b) Sagittal contrast material-enhanced T1-weighted MR image shows that the tumor (arrows) is homogeneously enhanced. (c) Photomicrograph (original magnification, x10; H-E stain) shows that the tumor cells have abundant eosinophilic cytoplasm and round nuclei and are growing in solid nodules. The patient’s elevated serum estradiol level (33.7 pg/mL [123.7 pmol/L]) decreased (<10 pg/mL [36.7 pmol/L]) immediately after right salpingo-oophorectomy.