Published: 2017-01-23

Case series of rare ovarian malignancy: granulosa cell tumor

Kavitha Yogini Duraisamy, Devi Balasubramaniam, Palanivelu Chinnusamy, Rashmi Barnwal


Granulosa cell tumors are rare ovarian sex cord stromal tumors characterized by indolent course and favorable prognosis. The treatment of granulosa cell tumor is individualized based on many factors like age, desire for future fertility and stage of the disease. Here, we report three cases out of which two were acute presentation and one was diagnosed incidentally when she got evaluated for menstrual irregularity. Fertility sparing surgery with proper staging is offered to young patients presenting in early stage. In patients who have completed family, comprehensive surgical staging including hysterectomy with bilateral salpingo oophorectomy is the standard treatment. Lymph node metastasis in granulosa cell tumor is very rare, hence pelvic and para aortic lymphadenectomy can be safely avoided if preoperative findings and frozen section favour granulosa cell tumor.


GCT, Fertility sparing surgery, Frozen section

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Kottarathil VD, Antony MA, Nair IR, Pavithran K. Recent advances in granulosa cell tumor ovary: a review. Indian J Surg Oncol. 2013:4(1):37-47.

Young RH. Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems. Mod. Pathol. 2005;18 (Suppl 2):S81-989.

Koukourakis GV, Kouloulias VE, Koukourakis MJ, Zacharias GA, Papadimitriou C, Mystakidou K, et al. Granulosa cell tumor of the ovary: tumor review. Integr Cancer Ther. 2008;7(3):204-15.

Sommers SC, Gates O, Goodof II. Late recurrence of granulosa cell tumors; report of two cases. Obstet Gynecol. 1955;6(4):395-8.

Fujita F, Eguchia S, Takatsukia M, Kobayashia K, Kanetakaa K, Ito M, et al. A recurrent granulosa cell tumor of the ovary 25 years after the initial diagnosis: A case report. Inte J Surg Case Reports. 2015;12:7-10.

Bjorkholm E, Silfversward C. Prognostic factors in granulosa-cell tumors. Gynecol. Oncol. 1981;11:261-74.

Lauszus FF, Petersen AC, Greisen J, Jakobsen A. Granulosa cell tumor of the ovary: a population-based study of 37 women with stage I disease. Gynecol. Oncol. 2001;81:456-60.

Gerkowicz S, Andrade F, Thompson RL, Garcia-Buitrago MT, Simpkins F, Pearson MJ et al. Adjuvant chemotherapy following complete gross resection of granulosa cell tumors of the ovary. Gynecologic Oncology. 2013;131(1):257.

Homesley HD, Bundy BN, Hurteau JA, Roth LM. Bleomycin, etoposide, and cisplatin combination therapy of ovarian granulosa cell tumors and other stromal malignancies: A Gynecologic Oncology Group study. Gynecol Oncol. 1999;72(2):131-7.

Maleemonkol S, Chareonium V, Isariyodom P, Faichamnan S. Granulosa cell tumor of the ovary. J Med Assoc Thai. 1996;79(10):648-53.

Cronje HS, Niemand I, Bam RH, Woodruff JD. Review of the granulosa-theca cell tumors from the emil Novak ovarian tumor registry. Am J Obstet Gynecol. 1999;180:323-7.

Fotopoulou C, Savvatis K, Braicu EI, Brink-Spalink V, Darb-Esfahani S, Lichtenegger W, et al. Adult granulosa cell tumors of the ovary: tumor dissemination pattern at primary and recurrent situation, surgical outcome. Gynecol Oncol. 2010;119:285-90.

Yim GE, Kim YT. Granulosa cell tumor of the ovary: time to launch a new prospective trial. J Gynecol Oncol. 2011;22(3):143-4.

Schmidt D, Kommoss. Diagnosis and differential diagnosis of granulosa cell tumor. F. Pathologe 2007;28:195.

Jaime Prat. Pathology of cancers of the female genital tract. Int J GynObs. 2015;131:S132-45.

Movahedi-Lankarani S, Kurman RJ. Calretinin, a more sensitive but less specific marker than alpha-inhibin for ovarian sex cord-stromal neoplasms: an immunohistochemical study of 215 cases. Am J Surg Pathol. 2002;26(11):1477-83.

Chadha S, van der Kwast TH. Immuno-histochemistry of ovarian granulosa cell tumours. The value of tissue specific proteins and tumour markers. Virchows Arch A Pathol Anat Histopathol. 1989;414(5):439-45.

Zanagnolo V, Pasinetti B, Sartori E. Clinical review of 63 cases of sex cord stromal tumors. Eur J Gynaecol Oncol. 2004;25(4):431-8.

Gershenson DM, Morris M, Burke TW, Levenback C, Matthews CM, Wharton JT. Treatment of poor-prognosis sex cord-stromal tumors of the ovary with the combination of bleomycin, etoposide, and cisplatin. Obstet Gynecol. 1996;87:527-31.

East N, Alobaid A, Goffin F, Ouallouche K, Gauthier P. Granulosa cell tumour: a recurrence 40 years after initial diagnosis. J Obstet Gynaecol Can. 2005;11:363-4.

Stenwig JT, Hazekamp JT, Beecham JB. Granulosa cell tumors of the ovary. A clinicopathological study of 118 cases with long-term follow-up. Gynec Oncology. 1979;7(2):136-52