The Multifaceted Granulosa Cell Tumours—Myths and Realities: A Review (original) (raw)

Ovarian granulosa cell tumor: Clinical features, treatment, outcome, and prognostic factors

North American Journal of Medical Sciences, 2014

Background: Granulosa cell tumors are rare neoplasms characterized by long natural history and favorable prognosis. Aims: The objective of this study was to determine the clinical presentation, treatment, outcome, and prognostic factors for patients of granulosa cell tumors. Materials and Methods: A retrospective analysis of 26 patients of granulosa cell tumor of ovary from 2002 to 2011 was carried out. The records of all patients were analyzed to determine clinical presentation, treatment, survival, and prognostic factors. Results: The median age of the patients was 50 years (range, 17-71 years). Abdominal pain was the most common presenting symptom. The median follow-up was 71.4 months (range, 21.6-149.9 months). The estimated 5 and 10 year overall survival (OS) was 84.6 and 72.5%, respectively. Event-free survival (EFS) was 76.5 and 52.9% at 5 and 10 years, respectively. Advanced stage was signifi cant independent poor prognostic indicator for both OS and EFS. Conclusion: Majority of the patients with granulosa cell tumors of the ovary present in early stage. Surgery is the primary treatment modality for granulosa cell tumors. Advanced stage and presence of residual disease were associated with inferior survival, but only prospective studies can ascertain their defi nite role.

Granulosa Cell Tumors of the Ovary: A Retrospective Tertiary Center Experience

Journal of clinical obstetrics & gynecology, 2021

Granulosa cell tumor (GCT) is a rare ovarian malignancy originating from sex cord-stromal cells. Sex cord stromal tumors account for 5-8% of all ovarian malignancies. 1 GCTs, which constitute approximately 70% of sex cord stromal ovarian tumors, are seen in 0.4-1.7 per 100,000 women. They are divided into 2 subgroups as juvenile (5%) and adult (95%) tumors based on their clinical presentation and histologic characteristics. The only clinically proven prognostic factor regarding recurrence is stage. However, patient age, tumor size, presence of intraperitoneal disease and the scope of the operation also play a role in prognosis. 2 Histological prognostic factors include nuclear atypia and mitosis. 3 Average recurrence is 5 years after surgery for the primary tumor. However, cases recurring even 20-30 years after the initial diagnosis have been reported in the literature. 4 Only 2% of GCT cases are bilateral, and most cases are diagnosed at Stage 1. Synchronous GCT has also been reported very rarely. They are usually lowgrade tumors with good prognosis. The most common presentation includes abdominal pain and distention. 5 Also they can secrete estrogen. Endometrial thickness should be evaluated with transvaginal ultrasound

Adult Granulosa Cell Tumor of the Ovary: A Retrospective Study of 40 Cases

Journal of Cancer and Tumor International, 2020

Background: Granulosa cell tumors (GCTs) are rare ovarian tumors represent only 5% of all ovarian cancers. GCTs are divided into an adult (AGCT) and juvenile (JGCT) types. The prognosis of these tumors is good when compared with other epithelial tumors. Radical surgery and adjuvant chemotherapy according to the presence of risk factors still the main line of treatment. Many Prognostic factors are suggested to affect the course of the disease like tumor stage and extend of surgery. But due to the small number of cases and indolent course of the disease, clinical characteristics and prognostic factors for this type of tumours still unclear. Aim: To determine the clinical characteristics of cases with AGCT and the prognostic factors for disease relapse and survival. Methods: This is a retrospective descriptive study. 40 patients with (AGCT) were recruited. Patient characteristics were collected. The disease-free interval and overall survival were determined. Results: At the end of the ...

Adult Granulosa Cell Tumor of Ovary: Clinical Study of 10 Cases

Indian Journal of Gynecologic Oncology, 2019

Purpose To evaluate the clinicopathological entities of adult granulosa cell tumor of ovary. Method A retrospective analysis of ten cases of adult granulosa cell tumor of ovary managed in a tertiary care center (VPS Lakeshore hospital, Kochi) from 2004 to 2018. Results Ten cases were identified to have adult granulosa cell tumor (GCT). Mean age was 45.3 years (range 31-63 years). Irregular cycles, palpable mass and pain abdomen were presenting complains. Palpable abdomino-pelvic mass was present in 7 (70%). Only one case had preoperative rise in serum Ca125 level. Serum inhibin analysis was done in postoperative period only, and one case had raised inhibin. Out of ten cases, 6 underwent laparoscopic surgery for adnexal mass and diagnosis of GCT was made in the final histopathology report. Five of them underwent completion surgery later on. Adjuvant chemotherapy was given in three of the cases. Total of 7 cases (70%) had recurrence. Pelvis was common site of recurrence, and mean duration of recurrence was 5.08 years (24-132 months). Mean disease-free period was 3.97 years (6-132 months). There were four mortalities. The longest follow-up duration for single case till the date was 13 years with recurrence in between. Conclusion Granulosa cell tumor of ovary is rare form of ovarian malignancy. Stage is the important prognostic factor. It has good prognosis compared to epithelial ovarian neoplasm. It is difficult to predict preoperatively. Care should be taken to prevent spillage while dealing with adnexal mass which occurs commonly in minimal access surgery and minilaparotomy.

Ovarian Adult Granulosa Cell Tumor: Report of 3 Cases

Journal of Clinical Case Reports, 2017

Granulosa tumors are rare malignant tumors of the ovary. There are two histological types: the adult form (95%) and the juvenile form (5%). They often occur in the adult population with extreme ages ranging from 40 to 70 years. The clinical signs are very variable with a slow evolution and a risk of recurrence that can go up to 30-40 years after the diagnosis. The radiological diagnosis is based on ultrasound data and magnetic resonance image (MRI). Radical surgical treatment is the basis of their therapeutic management.

A Cystic Granulosa Cell Tumor of Ovary: An Incidental Finding in a 50 years Old Lady

Annals of Pathology and Laboratory Medicine

Granulosa cell tumours (GCTs) are rare ovarian sex cord stromal tumours. GCTs usually are oestrogen producing neoplasms and hence consequently, symptoms related to hyperestrogenism are common at the time of diagnosis. Here we document a case of cystic GCT that was incidentally discovered on histopathological examination. An abdominal hysterectomy was done for abnormal uterine bleeding in a 50 years old lady, clinically was thought to be due to uterine fibroid. A unilateral oophorectomy was also done due to a small cyst in the left ovary, which on histopathological examination revealed cystic granulosa cell tumour in the ovary. Equipped with this knowledge, a better clinical correlation with the presenting symptoms could be made in future by clinicians and pathologists. The final diagnosis may change the prognosis and also the future treatment plan.

Ovarian Granulosa Cell Tumors: Retrospective Analysis of 18 Cases

2019

Background. Granulosa cell tumors (GCTs) are rare neoplasms and they represent about 2 to 5% of all ovarian cancers. They are usually detected at an early stage and have a relatively favorable prognosis. Aim. The aim of this study was to investigate the clinical and pathological characteristics of GCT patients and to identify the prognostic factors. Methods. In a retrospective study, we have analyzed the medical data of 18 patients with newly diagnosed GCTs treated by the Department of Gynecology and Obstetrics in the University Hospital Centre Zagreb in the period from January 2011 until December 2017. We have investigated data for age, parity, symptoms, tumor size, stage of disease, radicality of surgery, pathological characteristics of the tumors (number of mitosis, presence of Call-Exner bodies), application of adjuvant chemotherapy, time to progression of disease and overall survival. Results. Data from 18 cases were obtained. The median age was 55 years. The mean parity was 1,39. The most common clinical manifestations of the disease were abdominal pain (44%) and abdominal distension (44%). The mean tumor size was 11 cm (range 2-30 cm). The majority of our patients were stage I (78%, N = 14), while (22%, N = 4) were stage III. 15 patients underwent radical surgery, while in 3 patients fertility-sparing surgery was performed. According to the tumor characteristics, the mitotic count was high (> 10 mitosis/10 HPFs) in 9 cases (50%) and 7 patients had presence of Call-Exner bodies. Four patients received 1-6 cycles of adjuvant chemotherapy. During the follow-up period (median 49 months), 3 patients relapsed and one patient died free of the primary disease, from myocardial infarction. Conclusion. The basis of therapy in GCTs is surgical removal of the disease, and platinum-based adjuvant chemotherapy is recommended for advanced-stage GCTs. A prolonged follow-up period is necessary because they progress slowly and have a specifi c tendency for late recurrences.

Clinicopathological features of Adult Granulosa Cell Tumour of OvaryA Case Series of 14 Cases

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Adult Granulosa Cell Tumour (AGCT) is the most common sex cord stromal tumour of ovaries. These tumours in comparison with epithelial tumours are of low-grade malignant potential and have low recurrence rate after surgical procedure. In this case series, a retrospective search for ovarian AGCT cases from January 2016 till January 2021 was done. A total of 14 cases were included. Parameters studied in this case series were age, laterality, gross, architectural pattern, call Exner bodies, nuclear grooves, necrosis, mitotic count and tumour staging. After studying all the cases, it was reported that mean age of presentation was 44 years (range 21-64 years), unilateral with right-sided dominance (71.4%), grossly 78.5% of the cases were solid cystic with haemorrhagic area, with mean tumour size of 9 cm, 57.1% cases had call Exner bodies, and all the cases showed nuclear groves. Most of the cases, 85.7% presented with low mitotic count of <4/10 High Power Field (HPF). Rare presentation...

Adult Granulosa Cell Tumor of the Ovary: A Clinico Pathologic Study of 35 Cases

Tumori Journal, 1998

Aims and background: Adult granulosa cell tumor has a low malignant potential but requires an extensive follow-up of more than 5 years to accurately assess tumor activity. The aim of the present study was to evaluate the clinical characteristics, the treatment and the outcome of this rare ovarian tumor. Study design: A retrospective review of 35 cases treated at pri•