Ovarian tumors of sex-cord stromal derivation rarely exfoliate malignant cells in serous effusions. Adult granulosa cell tumor (AGCT) often presents as a stage I disease and association with ascites is about 10%. AGCT is rarely known to exfoliate tumor cells in the ascitic fluid. Exfoliation of malignant cells in the pleural fluid is rarer and has not been described previously in literature to the best of our knowledge. We report a case of AGCT presenting as stage IV disease with exfoliation of malignant cells in the pleural and ascitic fluid with exudative effusions. We wish to emphasize on cytomorphologic features of AGCT to differentiate the same from malignant epithelial tumors. A precise diagnosis in such a case may be possible on serous body fluid cytology with a combined clinical and cytopathologic approach.
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