Rare ovarian granulosa tumors: A retrospective analysis

Authors : Ayse Konac, H. Serpil Bozkurt

Pages : 35-41

Doi:10.35514/mtd.2024.109

View : 34 | Download : 70

Publication Date : 2024-08-31

Article Type : Research Paper

Abstract :Objective: Granulosa cell tumors (GCTs) of the ovary, a specific subtype of sex cord-stromal tumors, comprise approximately 5-8% of all ovarian cancers. Unlike the more prevalent ovarian epithelial tumors, GCTs are noted for their unique origin, clinical behavior, and prognostic outcomes. Characterized generally as low-grade malignancies, they often present with a favorable prognosis. Despite this, the clinical presentation, response to treatment, and long-term outcomes can vary significantly among patients. This study aims to provide an in-depth examination of the clinical and pathological features of ovarian granulosa cell tumors in a select group of 17 patients diagnosed with GCTs from a larger cohort of 596 individuals evaluated at our institution. By analyzing demographic and clinical variables such as age at diagnosis, symptomatology, radiological and surgical findings, and follow-up data, this study seeks to uncover patterns that could influence prognosis and inform therapeutic strategies. Ultimately, the objective is to deepen understanding of GCTs, enhance patient management, and contribute to the ongoing discourse in the field of gynecologic oncology. Materials and Methods: This extensive retrospective study initially reviewed the clinical data of 596 patients treated at Istanbul Training and Research Hospital between January 2017 and February 2023. From this broader cohort, 17 patients were specifically diagnosed with ovarian granulosa cell tumors. The data extraction focused on relevant details from these 17 cases, including age at diagnosis, menopausal status, initial symptoms, detailed radiological findings, serum CA-125 levels at presentation, and FIGO stage at diagnosis. Surgical reports were reviewed to document the type of surgical interventions performed, noting whether procedures were limited to unilateral salpingo-oophorectomy or included more extensive surgeries such as total abdominal hysterectomy and bilateral salpingo-oophorectomy. The presence of any adjuvant therapies, such as chemotherapy or radiation, was also recorded. Follow-up data were systematically collected to monitor outcomes including recurrence rates and any long-term complications. Results: Patients ranged in age from 39 to 64 years, with a median age of 47 and a mean age of 50.41. About 52.9% were premenopausal at diagnosis. The most common presenting symptoms included abdominal mass (82.4%), dysmenorrhea (29.4%), abdominal pain (17.6%), and cervical lymphadenopathy (70.6%). Radiological imaging showed cystic masses in 41.17% of patients and mixed cystic-solid components in 17.64%. The average tumor size was 7 cm (range 2-20 cm). No endometrial proliferation was noted, and there were no instances of recurrence or metastasis during the follow-up period. FIGO staging was utilized for clinical staging. Elevated levels of the serum tumor marker CA-125 were observed in 47.1% of the patients, indicating a significant presence of this biomarker, which is often associated with ovarian pathology. Conclusion: Ovarian granulosa cell tumors exhibit a favorable prognosis with a very low risk of recurrence. This study underscores the importance of a multidisciplinary approach in treatment, emphasizing the need for patient involvement in decision-making. Surgical intervention remains crucial, with the type and extent of surgery tailored to individual clinical scenarios. Continued research is necessary to further understand the pathophysiology of these tumors and improve patient outcomes. Early detection and appropriate management are key to preventing recurrences and ensuring long-term health.
Keywords : Over Granüloza Hücre Tümörü, Prognostik Faktörler, Kemoterapi, Over Tümörleri