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#576 Undiagnosed granulosa cell ovarian tumors in patent who underwent mine laparotomies and multi organ removal due to recurrent ascites and growing pseudocyst
  1. Krzysztof Nowosielski1,
  2. Slawomir Mrowiec2,
  3. Robert Król3 and
  4. Michal Krawczyk1
  1. 1Department of Gynecological Oncology, University Clinical Center, Medical University of Silesia, Katowice, Poland
  2. 2Department of Digestive Tract Surgery, University Clinical Center, Medical University of Silesia, Katowice, Poland
  3. 3Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland


Introduction/Background Granulosa cell ovarian tumors (GCT) originate from sex cords and the ovarian stroma. What is characteristic of these tumors is usually low dynamics of the disease and often very late relapses. As those tumors are relatively rare, the detection and treatment might be delay by late diagnosis.

Methodology The aim of the paper is to present a case of a woman diagnosed finally with GCT after the history of 9 laparotomies and recurrent ascites.

Results A 41-years old patient was admitted to the University Clinical Center in Katowice due to recurrent ascites of unknown etiology. The patient demonstrated symptoms of severe abdominal pain. She reported history of nine laparotomies, hysterectomy with adnexectomy, partial removal of the rectum and sigmoid, the creation of the colostomy, appendectomy, transverse colon resection and multiple peritoneal drainages. Some perihepatic cyst and ascites were detected on imagining (CT, MRI).

Ca-125 was normal. During the hospitalization the patient was consulted with surgeons, anesthesiologists, internists, gastroenterologists and radiologists. The multidisciplinary board decided to perform laparotomy with pseudocyst and ascites removal. During the operation, pseudocyst containing tissue-like structure were removed. Due to the hepatic bleeding, abdominal packing was performed. Finally, after next two laparotomies, the hemostasis was obtained, and the abdominal wall was closed with sutures. The patient recovered well. The histopathological examination revealed GCT, FIGO stage IV. The patient was planned for chemotherapy. However, 8 weeks after discharge from the hospital, the patient’s condition deteriorated. She finale died due to multi-organ failure.

Conclusion GCTs are potentially curable neoplasms of the ovary with low treatment failure rates. Proper diagnosis on the early stage may help in introducing right treatment and help patients to recover.

Disclosures none

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