Granulosa cell tumors: A study about 7 cases

##plugins.themes.academic_pro.article.sidebar##

Published Jan 17, 2011
Download
pdf
Vol. 89 No. 1 (2011): Issue Jan 2011

##plugins.themes.academic_pro.article.main##

Dorra Zeghal Souki
Haifa Bouchahda
Mehdi Kehila
Sami Mahjoub

Abstract

Background: The granulosa tumors have been described for the first time in 1855 by Rokitansky.
Aims: To investigate the epidemiological and pathological characteristics of granulosa tumors, and the prognostic factors to determine therapy management.
Methods: Our study is retrospective about 7 cases of granulosa cells tumors treated and monitored at the department C of Gynecology and Obstetrics in the Center of Maternity and Neonatology of Tunis.
Results: The average age of our patients was 40 years. The circumstances of discovery are dominated by pelvic pain (3cases); menometrorrhagia and post-menopausal bleeding (2 cases) and secondary amenorrhea (2 cases). The sonographic most frequent aspect was solido-cystic (3 cases). The final pathologic examination revealed 6 cases of granulosa adult type tumor and one juvenile type.
Five tumors were classified as stage Ia, one tumor was stage Ic and one stage IIa. The treatment was conservative in most cases. An ilioobturator and para-aortic lymphadenectomy was performed in 3 cases. Two patients had adjuvant chemotherapy. Six patients were in complete remission at the last inspection. There were two cases of pregnancies carried till birth after surgical treatment.
Conclusion: The granulosa tumors are characterized by their natural history with a slow and indolent character and their secretion of sex hormones.

Keywords:

Granulosa cell tumor, ovarian tumor, sex cord gonadal stromal tumors

##plugins.themes.academic_pro.article.details##

References

  1. Gittleman AM, Price AP, Coren C, Akhtar M, Donovan V, Katz DS. Radiology-pathology conference juvenile granulosa cell tumor. Clin Imaging 2003; 27: 221-4.
  2. Young RH, Scully RE. Ovarian sex cord-stromal tumours: recent advances and current status. Clin Obstet Gynaecol 1984; 11: 93- 134.
  3. Ozols RS, Schwartz PE , Eifel PJ. Ovarian cancer, fallopian tube carcinoma and peritoneal carcinoma. Cancer: principles and practice of oncology 2001:1597-1635.
  4. Malmstrom H, Hogberg T, Risberg B, Simonsen E. Granulosa cell tumors of the ovary: prognostic factors and outcome. Gynecol oncol 1994; 52: 50-5.
  5. Miller BE, Barron BA, Wan JY, et al. Prognostic factors in adult granulose cell tumor of the ovary. Cancer 1997; 79: 1951-5.
  6. Bjorkholm E , Pettersson F. Granulosa-cell and theca-cell tumors. The clinical picture and long-term outcome for the Radiumhemment series. Acta Obstet Gynecol Scand 1980;59: 361-5.
  7. Schweppe KW, Beller FK. Clinical data of granulosa cell tumors. J Cancer Res Cli Oncol 1982 ; 104:161-9.
  8. Unkila-kallio L,Titinen A , Walhstrom T et al. Reproductive features in women developing ovarian granulosa cell tumour at a fertile age. Hum Reprod 2000; 15:589-93.
  9. Tavassoli FA, Mooney E, Gersell DJ, et al. Sex cord-stromal tumours. Nat Clin Pract Oncol 2003; 2:146-61.
  10. Stuart GCE, Dawson LM. Update on granulosa cell tumours of the ovary. Curr Opin Obstet Gynecol 2003;15: 33-7.
  11. Ellouze S, Krichen-Makni S, Trabelsi K. Tumeur de la granulosa de l'ovaire : À propos de 16 cas. J Gynecol Obstet Biol Reprod 2006; 35: 767-72.
  12. krishnan A, Murdock C, Allard J, et al. Pseudo-isolated FSH deficiency caused by an inhibin B-secreting granulosa cell tumors: case report. Hum Reprod 2003; 18: 502- 5.
  13. Kurithara S, Hirakawa T, Amada S et al. Inhibin-producing ovarian granulosa cell tumor as a cause of secondary amenorrhea: case report and review of the literature. J Obstet Gynaecol Res 2004; 30:439-43.
  14. Laffargne F., Charlier C.Le syndrome féminisant des tumeurs endocrines de l'ovaire de l'ovaire. Gynécologie 1992 ; 43:178-80.
  15. Nakashima N., Young R.H., Scully R.E. Androgenic granulosa cell tumors of the ovary. A clinico-pathologic analysis of 17 cases and review of the literature. Arch Pathol Lab Med 1984; 108: 786- 91.
  16. Savage P, Constenla D, Fisher C, et al. Granulosa cell tumor of ovary: demographics, survival and the management of advanced disease. Clin Oncol 1998; 10: 242-5.
  17. Rey RA, Lhomme C, Marcillac I, et al. Antimullerian hormone as a serum marker of granulosa cell tumor of the ovary: comparative study with serum alpha-inhibin and oestradiol. Am J Obstet Gynecol 1996; 174: 958-65.
  18. Pautier P, Bidart JM, Lallou N, et al. Value of inhibin as a tumor marker in granulosa cell tumors. 6 new cases treated at the Gustave Roussy Institute. Bull Cancer 1995; 82: 557-60.
  19. Boggess JF, Soules MR, Goff BA et al. Serum inhibin and disease status in women with ovarian granulosa cell tumors. Gynecol Oncol 1997; 64: 64-9.
  20. Volders W, Billen M, Claes P, Gelin J, Palmers Y. Granulosa cell tumor of the ovary. J Belge Radiol 1998; 81:256.
  21. Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin Oncol 2003; 21: 1180-9.
  22. Pectasides D, Pectasides E, Psyrri A. Granulosa cell tumor of the ovary. Cancer Treat Rev 2008; 34: 1-12.
  23. Bjorkholm E, Silfversward C. Prognostic factors in granulosa-cell tumors. Gynecol Oncol 1981; 11:261-74.