Clinicopathological outcome of ovarian granulosa cell tumors.

OBJECTIVE: The aim of our study was to analyze the clinical and pathological characteristics of women who were diagnosed with malignant ovarian granulosa cell tumors and managed at single institution.

MATERIALS AND METHODS: A retrospective study was conducted regarding patients who were diagnosed with ovarian granulosa cell tumors and received treatment at King Hussein Medical Center. Data was extracted from the patient's files and reports from the period 2007 to 2017 (over ten years period). The collected data included patient's characteristics for age, parity, presenting symptoms, marital and menopausal status. Tumor characteristics included the site, size, mitotic index, type and associated uterine pathology. Other data included the type of surgery performed, adjuvant treatment provided, outcome data regarding tumor stage, recurrence and survival. Data was revised, arranged in tables and statically analyzed.

RESULTS: Twenty-one cases of ovarian granulosa cell tumors were identified. The median age of cases was 45.5 years (range of 17-76). Abdominal pain was the most common presenting symptom11/21 (52.4%). Endometrial hyperplasia was associated with ovarian tumor in six patients (28.6%) and endometrial cancer in three cases (14.3%). The primary surgery ranged from unilateral cystectomy to hysterectomy, bilateral salpingooophorectomy, and debulking surgery. Stage I-II were recorded in 18/21 (85.7%) of the cases, while stage III-V were found in 3/21 (14.3%). No adjuvant treatment was required in 11 cases (52.4%). Less than five years survival was 19% (4/21). Over all recurrence rate was 23.8%.

CONCLUSION: Granulosa cell tumors is a rare ovarian malignancy. Surgery is the standard treatment with a role for fertility preservation. Most tumors are diagnosed at an early stage with very good outcomes. Recurrence and survival are related mainly to initial tumor stage, however, further studies are needed to study the effect of other factors on outcome.