A clinicopathologic study of 92 cases of granulosa cell tumor of the ovary with special reference to the factors influencing prognosis

Abstract

Ninety‐two cases of granulosa cell tumor of the ovary have been studied. The clinical and pathologic data from this group were similar to that obtained in previous series. Because of the long natural history of many granulosa cell tumors, crude death rates over a relatively short period give little indication of the true malignant potential of these neoplasms and hence corrected survival rates were calculated; these show that, if no patient died from any other disease, approximately half of the women with this neoplasm would die, as a result of the tumor, within 20 years. Factors indicating a relatively poor survival rate were: age over 40 at the time of diagnosis, a presentation with abdominal symptoms, a palpable mass, a solid large tumor, bilateral tumors, extraovarian spread, and numerous mitotic figures in the tumor. It is suggested that all granulosa cell tumors should be considered as malignant and that the factors pointing to a poor prognosis are those indicating that a particular tumor has been diagnosed at a late stage in its natural history, either because it has been present for a long time or because it is highly malignant. There are no definite criteria for defining the prognosis in a case in which the tumor has been removed at any early stage in its natural life history.

Prognostic factors in adult granulosa cell tumor of the ovary

“…In accordance with the literature, most of the patients holm and Pettersson and Stenwig et al 1,4 and counters statements by Fox et al 5 All sections in the current studied in the current report had disease diagnosed as Stage I. However, because the mean tumor size was study were evaluated for nuclear atypia by one pathologist (E.S.)…”

“…However, the clinical differences between tumors in the NED and the REC patients (i.e., large studies. 5,7,13 Even large granulosa cell tumors are very homogehigher stage and larger tumor size) relate primarily to growth rate and especially to metastatic potential. As neous.…”

Prognostic significance of FOXL2 mutation and mRNA expression in adult and juvenile granulosa cell tumors of the ovary

“…Some assessed clinical parameters such as age at diagnosis, tumor size, surgical stage, serum tumor markers, tumor rupture during surgery, and adjuvant chemotherapy after the initial surgery. 3,6,9,[19][20][21][22] Others analyzed pathologic features such as cellular atypia, mitotic index, histologic subtype, presence of Call-Exner bodies, and tumor cell luteinization. 20,22 In our series, none of the clinical and pathologic features we analyzed correlated with outcome.…”

“…Only juvenile tumors extending beyond the ovary are associated with poor outcome. 6,7,9 Somatic mutation in the FOXL2 gene has been described as a potential 'driver' in the pathogenesis of adult granulosa cell tumors. 10 FOXL2 is an evolutionarily conserved single-exon gene of 2.7 kb located at 3q23 that encodes for a 376 aa protein belonging to the large family of forkhead transcription factors.…”

Retroperitoneal Recurrence in Ovarian Sex Cord Stromal Tumor with Annular Tubules 16 Years Later.

“…Nodal involvement at the time of recurrent disease was documented in 5% of cases in another series [18]. No disease recurrences were noted among women with primary tumors less than 7cm.Tumor size has been noted to be an important prognostic factor in many reports [19,20,21], and careful evaluation of women with larger lesions, especially over 7cm is warranted. In these series, tumors greater than 10-15cm were associated with an increased risk of recurrence and death from disease.…”