A case of adult granulosa cell tumor of the ovary with long-term survival after multiple recurrences

Objective: To illustrate the clinical course of a rare case of recurrent adult granulosa cell tumor (AGCT) and discuss the features and management for recurrences. Case report: A 56-year-old female was first diagnosed with AGCT in 2008 and had uneventful, regular follow-ups until 2013. Recurrence wa...

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Published inTaiwanese journal of obstetrics & gynecology Vol. 61; no. 5; pp. 883 - 888
Main Authors Pai, Angel Hsin-Yu, Wu, Ren-Chin, Liu, Feng-Yuan, Lin, Chiao-Yun, Lin, Yenpo, Lai, Chyong-Huey
Format Journal Article
LanguageEnglish
Published Elsevier 01.09.2022
Subjects
Adult granulosa cell tumor
Complete cytoreductive surgery
Megestrol acetate
Positron emission tomography
Recurrence
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Summary:Objective: To illustrate the clinical course of a rare case of recurrent adult granulosa cell tumor (AGCT) and discuss the features and management for recurrences. Case report: A 56-year-old female was first diagnosed with AGCT in 2008 and had uneventful, regular follow-ups until 2013. Recurrence was suspected and proven by computed tomography-guided biopsy. After undergoing complete cytoreductive surgery (CRS) followed by adjuvant megestrol acetate then leuprolide acetate, another recurrence sprouted at the presacral area in 2017. On both occasions, CRS with no visible residual tumor were attained. The patient has remained in complete remission to date with progestin therapy. Conclusion: There are currently no standardized tumor markers, imaging exams, or therapies for managing AGCT recurrences. Whole exome sequencing analysis of our patient suggested possible association with triosephosphate isomerase 1 mutation. Regular follow-ups with at least two types of imaging exams and indefinite hormone therapy are crucial for this patient's remission.
ISSN:1028-4559
DOI:10.1016/j.tjog.2022.06.006