Granulosa Cell Tumors of Ovary – A Systematic Review

Abstract

Granulosa cell tumors constitute less than 5 % of all ovarian tumors. Unlike epithelial ovarian tumors, they occur in a younger age group, are usually detected in an early stage and often have features of hyperestrogenism. They follow an indolent course and are characterized by a long natural history. Stage of the disease is the only factor which affects survival of these patients. Fertility preserving surgery is an acceptable option in young women with stage I A disease. For whom fertility is not an issue, total abdominal hysterectomy, bilateral salpingo-oophorectomy and removal of all gross disease is recommended. Nodal dissection is not recommended in surgical staging of GCT. Patients with early stage disease (stage I and II) have a very good prognosis with 5 year DFS and OS of 89% and 99% respectively and usually don’t require any postoperative treatment. Advanced stage disease (stage III and IV), the 5 year DFS and OS disease was 72% and 80 % respectively hence the option of postoperative treatment with BEP chemotherapy or taxane platinum based chemotherapy should be considered. 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 recommended.