Granulosa Cell Tumor Ovary: Review of Cases at a Tertiary Care Center

Dr Rajshekar S Kundargi; Dr Shruthi Shivdas; Dr Praveen Rathod; Dr Shobha K; Dr Pallavi Ram

Volume : VII, Issue : XI, November - 2018

Granulosa Cell Tumor Ovary: Review of Cases at a Tertiary Care Center

Dr Rajshekar S Kundargi, Dr Shruthi Shivdas, Dr Praveen Rathod, Dr Shobha K, Dr Pallavi Ram

Abstract :

Introduction: Granulosa cell tumors constitute less than 5 % of all ovarian tumors. Unlike epithelial ovarian tumors, they occur in a younger age group, are usually detected in an early stage and often have features of hyperestrogenism. Diagnosed by pelvic examination which is subsequently confirmed by radiologic studies. Whereas surgery provides definitive tissue diagnosis and staging. Total abdominal hysterectomy, bilateral salpingo–oophorectomy and removal of all gross disease is treatment for those who have completed their family. Fertility preserving surgery with unilateral salpingooophorectomy is the treatment preferred for younger women with stage Ia disease. GCT has features of prolonged natural history, relatively favourable prognosis and a tendency to late recurrences.

Methods: The study is performed period from July 2011 to June 2016 at Kidwai Memorial Institute of Oncology, a tertiary care center at Bangalore, Karnataka, India. The clinical data of patients who were treated in the institute for adult granulosa cell tumors of the ovary were collected retrospectively. Data for age, clinical manifestation, imaging, diagnosis and treatment of the patients were reviewed and analyzed. Post–operative histology was obtained for all patients.

Results: 41 cases were retrieved. The median patient age was 42 years. The most common clinical manifestations at diagnosis were abdominal pain and vaginal bleeding. In 15 (36.6%) tumor size was less than 10 cm whereas in 26(63.4%) tumor size was more than 10 cm. The majority of patients were in stage IA (43.9%), followed by stage IIIB (26.82% ). 12.19% patients were in stage IC, whereas 4.8% patients were in stage IV. In the follow–up period, 5 (12.1% ) patients relapsed.

Conclusions: Granulosa cell tumor of the ovary is an uncommon neoplasm. The adult form progresses slowly and often is diagnosed in an early stage of disease. Surgery is indicated. A prolonged post–therapeutic follow–up is necessary because of the risk of late recurrences, exceptionally for the adult form.