RESUMENAntecedentes: El tumor de células de la granulosa (TCG) ovárico es considerado una neoplasia de la cuerda sexual, de baja frecuencia, en su mayoría debuta en etapas tempranas, con patrón de crecimiento lento y puede presentar metástasis tardías. Objetivo: Presentar un caso clínico de metástasis pulmonares de TCG ovárico 26 años después del diagnóstico. Caso clínico: Mujer de 70 años, con antecedentes de TCG ovárico diagnosticado en 1976, tratado con histerectomía, salpingooforectomía bilateral y quimioterapia triasociada. En buenas condiciones generales hasta el 2002, detectándose múltiples nódulos tumorales pulmonares bilaterales correspondientes a metástasis de TCG. Recibió quimioterapia con platino y etopó-sido. Actualmente la paciente se encuentra viva, con enfermedad tumoral pulmonar de lento crecimiento. Conclusión: A lo mejor de nuestro conocimiento, se trata del tercer caso a nivel mundial de un TCG ovárico con metástasis pulmonares tardías, 26 años posdiagnóstico del tumor primario. Se señala el curso clínico de lenta evolución de esta neoplasia y la relevancia de los controles a largo plazo incluyendo niveles de estradiol o inhibina.PALABRAS CLAVE: Tumor de células de la granulosa, metástasis pulmonares, ovario SUMMARYBackground: Granulosa cell tumor of the ovary (GCT) of the ovary is a sex cord related tumor. It is a low frequency neoplasm with low clinical progression but it may show late metastases. Objective: To present a 70 year old female with a GCT of the ovary with multiple pulmonary metastases after 26 years from the initial diagnosis of the primary tumor. Clinic case: The patient had an ovarian GCT diagnosed by histology in 1976 and underwent hysterectomy, bilateral salpingoophorectomy and chemotherapy. The clinical course was satisfactory until 2002 when she presented with respiratory symptoms and images showing multiple bilateral pulmonary nodules that were histologically confirmed to be GCT metastases. The patient underwent chemotherapy with platinum and ethoposide. Actually the patient is alive with metastatic disease. Conclusion: To the best of our knowledge, this is the third case in medical literature of a GCT of the ovary with late pulmonary metastases 26 years after the initial diagnosis. This case illustrates the protracted clinical course of the neoplasm and the importance of the long term follow up including levels of estradiol and inhibin.
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