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OVARIAN GRANULOSA CELL TUMORS: A RETROSPECTIVE STUDY OF 14 CASES

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ESGO State of the Art 2018 Conference

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Abstract

Background: Granulosa cell tumors (GCT) are malignancies with relative favorable prognosis. The objective of this study was to determine the clinical presentation, pathological characteristics, outcome and prognostic factors for patients with GCT. Methods: A retrospective analysis of 14 patients of GST of ovary from 2003 to 2017 was carried out. Clinical and pathological information, sonographic findings, and treatment were obtained from medical records. Results: The average age of the patients was 54 years. 12 patients were at menopause. The most common clinical manifestation at diagnosis was vaginal bleeding. 5 of them presented ascites and one hemoperitoneum. The mean tumor size was 15cm (range, 2-23cm). GCT was always unilateral. The primary treatment consisted of surgery in all patients, based on the age of the patient. At histopathologic evaluation tumors were of adult-type. All cases were in stage IA grade1. For the patients prognosis are important: the presence of Call-Exner bodies (favorable factor) – 3 cases, cellular atypia - 5 cases and mitotic index - 3 patients more than 5/10HPF. One case was associated to endometrial adenocarcinoma. Recurrence occurred for 2 cases, one after 2 years in pelvis and the other one after 10 years with lung metastases. Conclusions: The GCT is one of the rarest forms of ovarian cancer – 1.06% in our study. It presents in early stage. We must think at an ovarian tumor with estrogen activity, when we find it at a women with postmenopausal bleeding. Prolonged surveillance is mandatory because GCT tend to recur years after the initial diagnosis.

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