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Granulosa cell tumor of the ovary.
J Clin Oncol 2003; 21(6):1180-9JC

Abstract

Adult granulosa cell tumor (GCT) of the ovary is oftentimes a hormonally active, stromal cell neoplasm that is distinguished by its ability to secrete sex steroids such as estrogen. Patients may present with vaginal bleeding caused by endometrial hyperplasia or uterine cancer as a result of prolonged exposure to tumor-derived estrogen. In addition, GCT is a vascular tumor that may occasionally rupture and result in abdominal pain, hemoperitoneum, and hypotension, mimicking an ectopic pregnancy in younger patients. GCT is usually associated with a mass on pelvic examination that is subsequently confirmed on ultrasonography. Surgery is required for definitive tissue diagnosis, staging, and tumor debulking. In older women, a total abdominal hysterectomy and bilateral salpingooophorectomy are typically performed. In women of childbearing age, a more conservative unilateral salpingo-oophorectomy may be performed, assuming that careful staging reveals that the disease has not extended outside of the involved ovary and that a concomitant uterine cancer has been excluded. Survival of patients with GCT is generally excellent because most patients present with early-stage disease, although certain high-risk patient groups may be identified. Stage is the most important prognostic factor, with a higher risk of relapse being associated with stages II through IV disease. In addition, patients with stage I disease associated with features such as large tumor size, high mitotic index, or tumor rupture may also be at higher risk in some series. The value of postoperative adjuvant therapy for high-risk patients has not been investigated by prospective randomized trials, which are difficult to perform because of the rarity of this tumor. Nonetheless, the use of adjuvant chemotherapy or radiation has sometimes been associated with prolonged disease-free survival in patients with high-risk features. Because of the propensity of GCT to recur years after initial diagnosis, prolonged surveillance with serial physical examination and serum tumor markers such as estradiol and inhibin is reasonable.

Authors+Show Affiliations

Program in Gynecologic Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. scannist@caregroup.harvard.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12637488

Citation

Schumer, Susan Tinsley, and Stephen A. Cannistra. "Granulosa Cell Tumor of the Ovary." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 21, no. 6, 2003, pp. 1180-9.
Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin Oncol. 2003;21(6):1180-9.
Schumer, S. T., & Cannistra, S. A. (2003). Granulosa cell tumor of the ovary. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 21(6), pp. 1180-9.
Schumer ST, Cannistra SA. Granulosa Cell Tumor of the Ovary. J Clin Oncol. 2003 Mar 15;21(6):1180-9. PubMed PMID: 12637488.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Granulosa cell tumor of the ovary. AU - Schumer,Susan Tinsley, AU - Cannistra,Stephen A, PY - 2003/3/15/pubmed PY - 2003/4/11/medline PY - 2003/3/15/entrez SP - 1180 EP - 9 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 21 IS - 6 N2 - Adult granulosa cell tumor (GCT) of the ovary is oftentimes a hormonally active, stromal cell neoplasm that is distinguished by its ability to secrete sex steroids such as estrogen. Patients may present with vaginal bleeding caused by endometrial hyperplasia or uterine cancer as a result of prolonged exposure to tumor-derived estrogen. In addition, GCT is a vascular tumor that may occasionally rupture and result in abdominal pain, hemoperitoneum, and hypotension, mimicking an ectopic pregnancy in younger patients. GCT is usually associated with a mass on pelvic examination that is subsequently confirmed on ultrasonography. Surgery is required for definitive tissue diagnosis, staging, and tumor debulking. In older women, a total abdominal hysterectomy and bilateral salpingooophorectomy are typically performed. In women of childbearing age, a more conservative unilateral salpingo-oophorectomy may be performed, assuming that careful staging reveals that the disease has not extended outside of the involved ovary and that a concomitant uterine cancer has been excluded. Survival of patients with GCT is generally excellent because most patients present with early-stage disease, although certain high-risk patient groups may be identified. Stage is the most important prognostic factor, with a higher risk of relapse being associated with stages II through IV disease. In addition, patients with stage I disease associated with features such as large tumor size, high mitotic index, or tumor rupture may also be at higher risk in some series. The value of postoperative adjuvant therapy for high-risk patients has not been investigated by prospective randomized trials, which are difficult to perform because of the rarity of this tumor. Nonetheless, the use of adjuvant chemotherapy or radiation has sometimes been associated with prolonged disease-free survival in patients with high-risk features. Because of the propensity of GCT to recur years after initial diagnosis, prolonged surveillance with serial physical examination and serum tumor markers such as estradiol and inhibin is reasonable. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/12637488/Granulosa_cell_tumor_of_the_ovary_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2003.10.019?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -