Functional neoplasms of the ovary are relatively infrequent compared to ovarian tumors in general, and only about 5% occur before puberty. While granulosa-cell tumors are the most common type of ovarian tumor, producing precocious puberty, they only account for about 10% of all the reported cases. Wilkins 1 mentioned one such experience in 20 years of endocrine practice, and Jolly,2 one case in his collection of 31 patients with sexual precocity and early adolescence. Eberlein and Bongiovanni 3 reported 2 cases of granulosa-cell tumor of the ovary associated with sexual precocity compared to 49 cases of constitutional precocity.
Although it is difficult to determine the exact incidence of granulosa-cell tumor, by 1955 Seckel 4 had collected 40 proved and 30 probable cases in a review of the literature. Pedowitz 5 mentioned 62 granulosa-cell tumors, including probable cases referred to by Seckel,4 and reported an additional instance in a