Successful Treatment of Adult Type Granulosa Cell Tumor of the Ovary - A Case Report and the Literature Review

Abstract

Introduction: Granulosa cell tumor (GCT) of the ovary is classified as a sex cord stromal tumor, representing approximately 2-5% of ovarian neoplasms, and adult type accounts 95% of all GCTs, usually occurs in women during 50-55 years old. The most important prognostic factor of this tumor is stage, with 10-year overall survival of 84-95% for stage I tumors, decreasing to 50-65% for stage II tumors, and to 0-22% for stage III and IV disease. Case report: A 56-year-old woman with left side ovarian granulosa cell tumor, at least clinical FIGO stage IIIa, underwent debulking operation on February 23rd, 2002. After surgery, she received four cycles adjuvant chemotherapy with the regimen of Bleomycin, Cisplatin and Etoposide. Then she received postoperative whole-abdomen and pelvis irradiation. The dose was given 2520 cGy in 21 fractions with liver and kidney shielding. After whole-abdomen and pelvis irradiation, she received pelvis boost with the dose of 1980 cGy in 11 fractions. Since then, she was regularly followed at our hospital until now without any signs of tumor recurrence nor tumor progression. Discussion: Until now there is no standard and proven treatment for GCT patients, especially when they suffered from advanced-stage or recurrent unresectable tumors. Complete tumor resection should be considered as the primary treatment. The optimal choice of combination platinum-based chemotherapy is still not well-defined. The role of adjuvant radiation therapy remains controversial. We suggested that adjuvant RT for patients with GCT might improve outcomes in selected patients.