Ovarian Granulosa Cell Tumors: A Retrospective Study of 21 Cases and a Review of the Literature

Background: Granulosa cell tumors are rare tumors with a relatively favorable prognosis. The aim of this study was to report the epidemiologic, anatomo-clinical characteristics and to determine treatment modalities and survival rates.

Methods: We retrospectively analyzed data from patients treated for granulosa cell tumors in our hospital over a 17-year period (1998-2015).

Results: Twenty-one cases were retrieved. The median age was 52 years. The most common clinical manifestations at diagnosis were post-menopausal bleeding and pelvic pain. Mean tumor size was 10 cm. 76.2% of the patients were diagnosed with a stage I disease. One patient (4.8%) underwent unilateral salpingo-oophorectomy, 4 patients (19%) underwent a total hysterectomy with unilateral salpingo-oophorectomy, while 15 patients (71.4%) underwent a total hysterectomy with bilateral salpingo-oophorectomy. One patient had only a biopsy. Relapse rate was 14.3% and the latest recurrence was seen 60 months after surgery. Actuarial 10-year relapse free survival (RFS) and overall survival (OS) were 85.7% and 90.5% respectively.

Conclusion: Granulosa cell tumor of the ovary is an uncommon neoplasm. The adult form progresses slowly and is often diagnosed in an early stage of disease. Surgery is the mainstay of treatment. A prolonged post-therapeutic follow-up is necessary because very late recurrences have been reported.

Keywords: Drug therapy; Granulosa cells; Ovarian neoplasms; Surgery