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Recurrence of granulosa cell tumor of the ovary 7 years after primary sparing surgery – case report and review of the literature

Adam Cieminski, Jan Lewandowski, Janusz Emerich

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2010, 9 (1), p. 58-62
Streszczenie

Granulosa cell tumor of the ovary is a rare gonadal tumor, accounting for 1-5% of all malignant ovarian tumors. It may take two histological forms: mature (95%), occurring mostly in the 5th decade, and juvenile, developing mostly in young women. In most cases, it is diagnosed at FIGO stage I. The tumor is hormonally active, secreting estrogens and/or, rarely, androgens. While being a slow-growing and moderately malignant, even after appropriate therapy, it often recurs several years after first diagnosis. We present a case of granulosa cell tumor of the ovary in a young woman, 7 years after diagnosis and correct, sparing surgical treatment. At laparoscopy, during tumor removal, the lesion has been torn apart, and also tumor tissue was detected in contralateral ovary, spared during primary surgery. Due to invasion of existing ovary and dissemination after tumor rupture at laparoscopy, radical surgery was opted for, with excision of existing adnexae, uterus and subsequent staging. Persistent tumor focus was found within the pelvic peritoneum. The patient was referred for adjuvant treatment by chemotherapy (the BEP protocol). Currently, management of granulosa cell tumor relies in surgery, both sparing (in the case of young women at an early clinical stage), and radical. An important aspect of treatment is adjuvant chemotherapy, rarely – radiotherapy. Recurrence rate is estimated at 10-33% of all cases, both within the pelvis and, even more frequently, out of it. Ten-year survival rate in patients with recurrence is estimated at 57%. A review of pertinent literature is included.

Słowa kluczowe
granulosa cell tumor of the ovary, surgical treatment, adjuvant chemotherapy, recurrence, review of literature