Multiple recurrence of granulosa cell tumor of the ovary: A case report and literature review

Introduction: Granulosa cell tumors comprise approximately 5% of all ovarian malignancy and account for 70% of malignant sex cord stromal tumors. Granulosa cell tumors have been diagnosed from infancy, the peak incidence being perimenopausal age. The potential of malignancy of these tumors is low, recurrences are often late and found in 10-33% of cases. Case Report: A 32-year-old P1L1 presented with large abdominal mass for which she underwent staging laparotomy with debulking surgery. She was a known case of granulosa cell tumor in the past and had undergone three laparotomies, along with chemotherapy. At the age of 13 yrs, she was diagnosed with a stage IA granulosa cell tumor (GCT) of the ovary first time. She underwent surgical staging and removal of left sided adnexal mass, after which she was asymptomatic for 7 years. In 2003 she again presented with lump abdomen for which she underwent resection of adnexal mass, histopathology was consistent with recurrent GCT. After second surgery she also received two cycles of chemotherapy. Despite adjuvant chemotherapy, patient presented again after three years in 2006 with adnexal mass and was found to have a third recurrence. At that time, she received 6 cycles of chemotherapy and the mass regressed. Meanwhile she got married and had one child. After four year in 2010 she again presented with lump abdomen and she underwent surgical staging, total abdominal hysterectomy with right salphingo ophorectomy along with removal of mass. After five year in 2015 she again presented with lump abdomen; there was a large pelvic mass which was removed and patient referred for chemotherapy. Discussion: GCTS which a rare malignant tumors of ovary tend to be associated with late recurrences. Although most recurrences occurs within 10 years after initial diagnosis, there are occasional reports of recurrences after10 years. We experienced the rare case of a patient who relapsed multiple times over 20 years, despite surgical and targeted treatment. Conclusion: The long history of granulosa cell tumor highlights the importance of extended follow up of the patient.

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Multiple recurrence of granulosa cell tumor of the ovary: A case report and literature review

10.1055/s-0039-1685296 ◽

2016 ◽

Author(s):

Varkha Chandra ◽

Sandhya Jain ◽

Neerja Goel ◽

Bindia Gupta ◽

Shalini Rajaram

Keyword(s):

Case Report ◽

Granulosa Cell ◽

Adnexal Mass ◽

Malignant Tumors ◽

Abdominal Mass ◽

Pelvic Mass ◽

Granulosa Cell Tumor ◽

Cell Tumor ◽

Surgical Staging ◽

Granulosa Cell Tumors

Introduction: Granulosa cell tumors comprise approximately 5% of all ovarian malignancy and account for 70% of malignant sex cord stromal tumors. Granulosa cell tumors have been diagnosed from infancy, the peak incidence being perimenopausal age. The potential of malignancy of these tumors is low, recurrences are often late and found in 10-33% of cases. Case Report: A 32-year-old P1L1 presented with large abdominal mass for which she underwent staging laparotomy with debulking surgery. She was a known case of granulosa cell tumor in the past and had undergone three laparotomies, along with chemotherapy. At the age of 13 years, she was diagnosed with a stage IA granulosa cell tumor (GCT) of the ovary first time. She underwent surgical staging and removal of left sided adnexal mass, after which she was asymptomatic for 7 years. In 2003 she again presented with lump abdomen for which she underwent resection of adnexal mass, histopathology was consistent with recurrent GCT. After second surgery she also received two cycles of chemotherapy. Despite adjuvant chemotherapy, patient presented again after three years in 2006 with adnexal mass and was found to have a third recurrence. At that time, she received 6 cycles of chemotherapy and the mass regressed. Meanwhile she got married and had one child. After four year in 2010 she again presented with lump abdomen and she underwent surgical staging, total abdominal hysterectomy with right salphingo ophorectomy along with removal of mass. After five year in 2015 she again presented with lump abdomen; there was a large pelvic mass which was removed and patient referred for chemotherapy. Discussion: GCTS which a rare malignant tumors of ovary tend to be associated with late recurrences. Although most recurrences occurs within 10 years after initial diagnosis, there are occasional reports of recurrences after10 years. We experienced the rare case of a patient who relapsed multiple times over 20 years, despite surgical and targeted treatment. In conclusion the long history of granulosa cell tumor highlights the importance of extended follow up of the patient.

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Female Genital Tuberculosis, a Rare Lesion Mimicking Ovarian Carcinoma, with Granulosa Cell Tumor: A Case Report

Tumori Journal ◽

10.1177/03008916211012332 ◽

2021 ◽

Vol 107 (1_suppl) ◽

pp. 3-3

Author(s):

RM Samaka ◽

AS Mohamed ◽

AY Abu-Zeid

Keyword(s):

Ovarian Cancer ◽

Differential Diagnosis ◽

Case Report ◽

Ovarian Carcinoma ◽

Granulosa Cell ◽

Adnexal Mass ◽

English Literature ◽

Granulosa Cell Tumor ◽

Cell Tumor ◽

Genital Tuberculosis

Introduction: Tuberculosis (TB) of the upper genital tract is a rare disease worldwide. TB should be always considered in the differential diagnosis of a pelvic or adnexal mass as it may diagnosed as ovarian carcinoma but both have completely different treatment. Therefore, recognition of TB is important for surgeons and histopathologists, in order to set a proper plan for management and avoid unnecessary extensive therapy. Granulosa cell tumor of the ovary is a rare type of ovarian cancer that accounts for approximately 2% of all ovarian tumors. This type of tumor is known as a sex cord-stromal tumor and usually occurs in adults. Thorough search in English literature revealed only 2 case reports showed combination between genital TB and granulosa cell tumor. Case summary: A 68 years old female patient complained of vaginal bleeding for four months. She had no personal or family history of TB. An ultrasound study showed a 2x1.5 cm mixed echogenic mass in the right adnexa. Based on her clinical and imaging findings which suggestive of ovarian cancer, the patient underwent panhystrectomy and bilateral salpingoophrectomy. The gross examination of the specimen revealed distended and coiled tubes with right adnexal mass measured 2x1.5 cm and dissection of the uterus revealed erythematous endometrium with yellowish secretions. The histopathologic assessment of right adnexal mass revealed malignant neoplasm *Granulosa cell tumor* formed of short polygonal cells arranged in diffuse sheets with patternless pattern. The malignant cells showed nuclear grooving. There was no necrosis or other ovarian neoplastic element. The histopathologic assessment of both tubes and endometrium revealed infiltration by multiple nodular granulomas. Each granuloma was formed of multinucleated giant cells and epithelioid cells rimmed by lymphocytes with occasional central caseation *genital tuberculosis*. Conclusion: The conclusion of this case report is to stress upon keeping genital TB in mind as a potential differential diagnosis for ovarian carcinoma.

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Adult Granulosa cell tumor: A small mass producing troublesome morbidity to a woman

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2018030 ◽

2018 ◽

Vol 08 (02) ◽

pp. 126-128

Author(s):

Khalida Nasreen ◽

Samreen Iqbal

Keyword(s):

Granulosa Cell ◽

Abdominal Mass ◽

Granulosa Cell Tumor ◽

Small Mass ◽

Cell Tumor ◽

Adult Type ◽

Granulosa Cell Tumors ◽

Large Size ◽

Present Case Study

Granulosa cell tumors are sex-cord stromal tumor ofovary, a rare neoplasmaccounting for approximately 3-5% of all ovarian malignancies. Hormone producing tumor, a total of 95% of all GCTs are adult type and of large size. A majority of women present with abdominal mass and diagnosis made on histopathology. While small size symptoms producing Granulosa cell tumors are rare and it’s a rare virilizing tumor of adolescents. Adult Granulosa cell tumor is a clinically and molecularly unique subtype of ovarian cancer. The present case study reports on a case of a small size Granulosa cell tumor producing postmenopausal bleeding in 56-year-old woman.

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Right trisectionectomy for liver metastasis of granulosa cell tumor: a case report and literature review

Surgical Case Reports ◽

10.1186/s40792-020-00880-3 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Itsuki Koganezawa ◽

Koichi Tomita ◽

Masashi Nakagawa ◽

Yosuke Ozawa ◽

Toshimichi Kobayashi ◽

...

Keyword(s):

Case Report ◽

Liver Metastasis ◽

Literature Review ◽

Granulosa Cell ◽

Granulosa Cell Tumor ◽

Cell Tumor

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Radiotherapy for the Treatment of Metastatic Granulosa Cell Tumor in the Mediastinum: A Case Report

Gynecologic Oncology ◽

10.1006/gyno.1998.5338 ◽

1999 ◽

Vol 73 (3) ◽

pp. 455-460 ◽

Cited By ~ 21

Author(s):

I-Wuen Lee ◽

Wilfred Levin ◽

William Chapman ◽

Ronn E.A. Goldberg ◽

K.Joan Murphy ◽

...

Keyword(s):

Case Report ◽

Granulosa Cell ◽

Granulosa Cell Tumor ◽

Cell Tumor

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Adult Testicular Granulosa Cell Tumor: A Review of the Literature for Clinicopathologic Predictors of Malignancy

Archives of Pathology & Laboratory Medicine ◽

10.5858/2009-0512-rsr.1 ◽

2011 ◽

Vol 135 (1) ◽

pp. 143-146 ◽

Cited By ~ 3

Author(s):

Joshua Anspach Hanson ◽

Abiy B. Ambaye

Keyword(s):

Granulosa Cell ◽

Case Reports ◽

Granulosa Cell Tumor ◽

Malignant Potential ◽

Cell Tumor ◽

Review Of The Literature ◽

Stromal Tumors ◽

Granulosa Cell Tumors ◽

Pathologic Features ◽

Sex Cord Stromal Tumors

Abstract Adult testicular granulosa cell tumors are rare sex cord–stromal tumors of which only 28 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. To date, there are no clinical or pathologic features that definitively predict malignancy. We reviewed all prior case reports for features that may predict their malignant potential. Tumor size greater than 5.0 cm is the only feature statistically associated with malignancy. Mitotic count, tumor necrosis, patient age, and the presence of gynecomastia do not, at present, predict benign versus malignant behavior.

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Abnormal Elevation of Anti-Mullerian Hormone and Androgen Levels Presenting as Granulosa Cell Tumor

Frontiers in Oncology ◽

10.3389/fonc.2021.641166 ◽

2021 ◽

Vol 11 ◽

Author(s):

Hongbin Chi ◽

Ning Huang ◽

Huamao Liang ◽

Rong Li ◽

Congrong Liu ◽

...

Keyword(s):

Granulosa Cell ◽

Polycystic Ovarian Syndrome ◽

Histopathological Examination ◽

Granulosa Cell Tumor ◽

Cell Tumor ◽

Embryo Cryopreservation ◽

Granulosa Cell Tumors ◽

Healthy Female ◽

Irregular Menses ◽

Ovarian Syndrome

We report a rare subtype of adult cystic granulosa cell tumor (AGCT) characterized by elevated anti-Mullerian hormone and hyperandrogenism. A 35-year-old woman with primary infertility, hyperandrogenism, and irregular menses who was previously diagnosed with polycystic ovarian syndrome was diagnosed with AGCT based on histopathological examination and FOXL2 genetic test after laparoscopy. Due to fertility aspirations, she underwent controlled ovarian stimulation followed by embryo cryopreservation before salpingo-oophorectomy, and two embryos were frozen-thawed and transferred after surgery. A healthy female infant was delivered at 40 weeks’ gestation. Cystic granulosa cell tumors should be considered a differential diagnosis in patients with persistent ovarian cysts and hyperandrogenism. Younger patients with AGCT with fertility goals should consider active assisted reproduction measures to preserve fertility before treatment for AGCT.

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