A Recurrent Granulosa Cell Tumor of the Ovary After 20 Years
Tóm tắt
Adult-type granulosa cell tumors of the ovary are rare tumors. These tumors characteristically have high recurrence rates (10–15%), sometimes many years after the original diagnosis, and so lifelong follow is warranted for these patients. A 52-year-old female presented with a history of hysterectomy with ovarian mass removal 20 yrs back. She presented with huge abdominopelvic mass. Imaging showed abdominopelvic mass (18 × 10 × 24 cm), adherent to large bowel with multiple liver metastases (subcapsular and parenchymal largest 46 × 47 mm). Inhibin B (240 pg/ml) was raised. Exploratory laparotomy followed by ovarian mass removal, bowel resection anastomosis with proximal ileostomy and removal of hepatic metastasis was done. It was a suboptimal surgery, and residual disease was a 2-cm nodule near porta hepatis. Post-surgery inhibin was 70 pg/ml. Postoperatively, she received 6 doses of adjuvant chemotherapy (carboplatin and paclitaxel) and on regular follow-up. Due to high chance of recurrence even years after apparent clinical cure of the primary tumor, lifelong follow-up with clinical examination and tumor markers like inhibin B is required.
Tài liệu tham khảo
Wang P-H, Sun H-D, Lin H, Wang K-L, Liou W-S, Hung Y-C, et al. Outcome of patients with recurrent adult-type granulosa cell tumors—a Taiwanese gynecologic oncology group study. Taiwan J Obstet Gynecol. 2015;54(3):253–9.
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(3):456–60.
Abu-Rustum NR, Restivo A, Ivy J, Soslow R, Sabbatini P, Sonoda Y, et al. Retroperitoneal nodal metastasis in primary and recurrent granulosa cell tumors of the ovary. Gynecol Oncol. 2006;103(1):31–4.
Fotopoulou C, Savvatis K, Braicu E-I, 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(2):285–90.
Borah T, Das A, Panda S, Singh AS. Acute abdomen with hemoperitoneum in a postmenopausal woman. J Mid-Life Health. 2010;1:89–90.
Teoh D, Freedman R, Soliman PT. Nearly 30 years of treatment for recurrent granulosa cell tumor of the ovary: a case report and review of the literature. Case Rep Oncol. 2010;3(1):14–8.
Park J-Y, Jin KL, Kim D-Y, Kim J-H, Kim Y-M, Kim K-R, Kim Y-T, Nam J-H. Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary. Gynecol Oncol. 2012;125:80–6.
Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin Oncol. 2003;21:1180–9.
Hardy RD, Bell JG, Nicely CJ, Reid GC. Hormonal treatment of a recurrent granulosa cell tumor of the ovary: case report and review of the literature. Gynecol Oncol. 2005;96(3):865–9.
Van Meurs HS, Van Lonkhuijzen LRCW, Limpens J, Van der Velden J, Buist MR. Hormone therapy in ovarian granulosa cell tumors: a systematic review. Gynecol Oncol. 2014;134(1):196–205.