Granulosa Cell Tumor of the Ovary: Tumor Review

Abstract

Granulosa cell tumors of the ovary are rare neoplasms that originate from sex-cord stromal cells. The long natural history of granulosa cell tumors and their tendency to recur years after the initial diagnosis are the most prominent of their characteristics. The secretion of estradiol is the reason for signs at presentation such as vaginal bleeding and precocious puberty. Abdominal pain and hemoperitoneum, which occasionally can occur, are attributable to tumor rupture. The most common finding in pelvic examination is a tumor mass, which is subsequently confirmed with imaging techniques. Surgery is the mainstay of initial management for histological diagnosis, appropriate staging, and debulking. A more conservative unilateral salpingo-oophorectomy is indicated in patients with stage I disease and patients of reproductive age. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is the appropriate surgical treatment for postmenopausal women and those with more advanced disease. The stage of disease is the most important prognostic factor associated with the risk of relapse. There are no clear conclusions regarding the role of postoperative chemotherapy or radiotherapy in stage I disease and in those with completely resected tumor. The use of adjuvant chemotherapy or radiotherapy has sometimes been associated with prolonged disease-free survival and possibly overall survival. Chemotherapy is the treatment of choice for patients with advanced, recurrent, or metastatic disease, and BEP (bleomycin, etoposide, and cisplatin) is the preferred regimen. Although the overall rate of response to treatment is high, the impact of treatment on disease-free or overall survival is unknown. Prolonged surveillance is mandatory because tumors tend to recur years after the initial diagnosis.

Recent Advances in Granulosa Cell Tumor Ovary: A Review

“…Epithelial ovarian tumors especially the mucinous variety may also secrete inhibin (82 % cases); showing inhibin is not specific for GCT. Inhibin levels fall to normal range around 1 week after tumor removal, suggesting inhibin could be secreted either by the tumor tissue or surrounding normal ovarian tissue [21]. MIS are formed in granulosa cells during reproductive life.…”

Hemoperitoneum Secondary to Arterial Rupture of Subserosal Uterine Leiomyoma

“…Rupture of granulosa cell tumors has been estimated to be between 10% and 35% and is associated with presenting complaints of abdominal pain, distension, and hypotension consistent with hemoperitoneum. (12) Additionally, rupture of fibrothecoma, clear cell tumors, and ovarian adenocarcinoma have been identified as causing hemoperitoneum. (13)(14)(15) Thus, malignancy is a key differential to keep in mind in a patient presenting with signs and symptoms of intraabdominal hemorrhage.…”

Case series of rare ovarian malignancy: granulosa cell tumor

“…1 It is a type of sex cord stromal tumor, characterized by a prolonged natural history and a tendency to late recurrence. 2,3 Most of the cases occur in post-menopausal women but one third cases occur in reproductive age group and premenopausal women. 4 A juvenile form occurs in children and young women and has distinct clinical and pathologic features (hyperestrogenism and precocious puberty).…”