Retroperitoneal nodal metastasis in primary and recurrent granulosa cell tumors of the ovary
Introduction
Granulosa cell tumors are rare neoplasms of the ovary that are similar to other tumors that arise from the ovary and can metastasize, recur, and cause death; however, due to their rarity, limited data are available on patterns of nodal metastasis at initial surgery and sites of disease at recurrence. Currently, there is no specific preoperative diagnostic modality to help identify patients with granulosa cell tumors and facilitate referral to a subspecialist; thus, general gynecologists usually initially explore the majority of cases. Limited data are available on the results of comprehensive surgical staging for this disease and the incidence of lymph node metastasis at the time of initial diagnosis is lacking; however, retroperitoneal pelvic and paraaortic nodal recurrences have been observed with this disease as an isolated event or part of multisite recurrence. We conducted this study to describe the incidence of nodal metastasis in women newly diagnosed with ovarian granulosa cell tumors and describe the incidence of retroperitoneal involvement in patients at first recurrence of this disease.
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Materials and methods
Following institutional review board approval, we conducted a retrospective chart review of all patients with ovarian granulosa cell tumors managed as inpatients from January 1990 to July 2005. Patients were identified using the Virginia K. Pierce Gynecology Service database. The initial date of diagnosis ranged from1971 to 2005. We excluded patients who were seen in the outpatient setting for consultation only; this included patients seen for second opinion consults or those who were managed
Results
We identified 68 patients with documented ovarian granulosa cell tumors who were managed as inpatients at our institution during the study period. The median age was 49 years (mean, 47.5 years; range, 19–78 years). Past gynecologic surgical history included 3 patients with prior total abdominal hysterectomy with unilateral salpingo-oophorectomy, 2 with prior total abdominal hysterectomy, and 2 with prior unilateral salpingo-oophorectomy. All these procedures were performed for benign disease.
Discussion
Adult granulosa cell tumors are rare ovarian malignancies that are commonly initially encountered by general gynecologists during management of an ovarian mass. The vast majority of cases are presumed stage I disease, even though complete staging is rarely performed at diagnosis. It is estimated that the majority if women with apparent stage I disease do well and may never seek consultation with or be referred to a gynecologic oncologist until a recurrence is detected at which point a
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Serial cytoreductive surgery and survival outcomes in recurrent adult-type ovarian granulosa cell tumors
2024, American Journal of Obstetrics and GynecologyGerm cell, stromal, and other ovarian tumors
2023, DiSaia and Creasman Clinical Gynecologic OncologyDoes uterine preservation affect survival outcomes of patients with stage I ovarian sex cord-stromal cell tumours? A multi-institutional study
2020, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :The cumulative incidence of recurrent tumours, mainly in the peritoneum, was approximately 10 % in both groups, and there was no significant difference in frequency. As the most common site of recurrence of sex cord-stromal tumours is in the pelvis [21], there is a need to observe disease progression in the peritoneal cavity carefully, even after complete resection of stage I tumours. On the other hand, some patients develop late tumour recurrence, which is a special characteristic of sex cord-stromal tumours [5]; 5 % of all patients in the present study exhibited late tumour recurrence.