Adult granulosa-cell tumor of the ovary: a retrospective study of 45 cases

Abstract

This study describes 45 cases of adult granulosa-cell tumors seen in our institution between 1976 and 1993. The median age was 46.5 years (12-77) and 18 women were postmenopausal. Vaginal bleeding was present in one-third of cases; other complaints were abdominal pain (28%) and the presence of a pelvic mass (47%). The tumor size was variable (<3 cm to 30 cm, median 11.5 cm). FIGO stages were: stage I: 30 (73%) (19 Ia, seven Ic, four I unknown); stage II: seven (17%) (two IIa, five IIC); stage III: three (7%) (one IIIb, two IIIc). Two adenocarcinomas and 13 cases of hyperplasia were found in 25 endometrial samples available. The initial therapy for all the cases was surgery, consisting in 34 patients of hysterectomy, bilateral salpingo-oophorectomy, +/- tumor resection. Sixteen patients received adjuvant therapy as well: chemotherapy (CT) alone for 12, radiotherapy (RT) alone for two, and CT + RT for two patients. Among the 39 patients who achieved a complete response after initial therapy, 15 patients have relapsed (pelvic recurrences) (38.5%) including six stage Ia (three received only conservative surgery). All the recurrent tumors were resected and 14/15 had CT (13/14 with cisplatin). The overall survival rate was 77.2% at 5 years, 66.5% at 10 years, and 41.2% at 20 years. A statistically significant difference was found between the survival of patients with stage Ia disease (75% at 10 and 15 years) and that of other patients (60% at 10 years, and <50% at 15 years). Serum estradiol and serum inhibin were measured in some patients and the results are described.

Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases

“…Although the extent of the initial surgical procedure is still controversial and not standard, some authors reported higher relapse rates in cases of conservative surgery and better survival in cases with radical surgery. 11 In patients of childbearing age with desire for future fertility, fertility saving surgery seems to be acceptable. However, a comprehensive staging procedure should again be performed since the pattern of spread seems to include peritoneal surfaces similar to epithelial ovarian carcinoma.…”

Sex cord-stromal tumors of the ovary: a comprehensive review and update for radiologists

“…Estrogen overproduction is also responsible for endometrial hyperplasia and concomitant endometrial cancer, which according to the literature occur in 32%-85% and 3%-22% of cases, respectively (33,34). Uterine cancer is nearly always a low-grade, low-stage endometrioid adenocarcinoma (35).…”

Tumeurs juvéniles de la granulosa : expression clinique et moléculaire

“…Nous n'avons pas retrouvé ce facteur pronostique dans notre série. Le stade est un des rares facteurs qui fait l'objet d'un consensus [26,[28][29][30] (Tableau 1) : la médiane de survie pour les stades III et IV est de cinq ans, alors qu'elle est supérieure à 25 ans pour les stades I. Un stade avancé serait plus souvent impliqué dans la survenue de récidive et serait prédictif d'une tumeur hautement proliférative [27]. Ainsi, quatre des six patientes, avec une récidive que nous rapportons, présentaient une extension tumorale extraovarienne d'emblée [11].…”