A Recurrent Granulosa Cell Tumor of the Ovary After 20 Years

Abstract

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.