The longest period to recurrence of granulosa cell ovarian tumor: 41 years after initial diagnosis

Granulosa cell tumors (GCTs) are characterized by slow growth, local spread, and late recurrence. The authors report the case unique for both unusually large dimensions of the recurring tumor and the fact that it was confined only to the omentum, where it has recurred 41 years after the initial surgery including salpingo-oophorectomy. This is the longest reported period from initial diagnosis to the recurrence of GCT. This case report is important as it proves that recurrence of GCT is possible even after an extremely long period of time after the initial surgery, due to the nature of this tumor, and the inhibition of apoptosis process.

Granulosa cell tumor; Ovary; Omentum; Relapse; Apoptosis.

[1] Mancari R., Portuesi R., Colombo N.: “Adult granulosa cell tumours of the ovary”. Curr. Opin. Oncol., 2014, 26, 536.

[2] Khosla D., Dimri K., Pandey A.K., Mahajan R., Trehan R.: “Ovarian granulosa cell tumor: clinical features, treatment, outcome, and prognostic factors”. N. Am. J. Med. Sci., 2014, 6, 133.

[3] Crew K.D., Cohen M.H., Smith D.H., Tiersten A.D., Fiert N.M., Hershman D.L.: “Long natural history of granulose cell tumor of the ovary 23 years after initial diagnosis: A case report and review of the literature”. Gynecol. Oncol., 2005, 96, 235.

[4] Ugianskiene A., Grove A., Soegaard-Andersen E. “Adult granulosa cell tumor of the ovary: a retrospective study of 37 cases”. Eur. J. Gynaecol. Oncol., 2014, 35, 621.

[5] Iyibozkurt A.C., Topuz S., Gungor F., Akhan S.E., Demirci F., Salihoglu Y., Berkman S., Bengisu E.: “Factors affecting recurrence and disease-free survival in granulosa cell tumors of the ovary”. Eur. J. Gynaecol. Oncol., 2010, 31, 667.

[6] Oztekin D., Kurt S., Camuzcuoglu H., Balsak D., Dicle N., Tinar S.: “Granulosa cell tumors of the ovary: review of 43 cases”. J. BUON, 2012, 17, 461.

[7] Thomakos N., Biliatis I., Koutroumpa I., Sotiropoulou M., Bamias A., Liontos M., Vlachos G., Rodolakis A.: “Prognostic factors for recurrence in early stage adult granulosa cell tumor of the ovary”. Arch, Gynecol, Obstet., 2016, 294, 1031

[8] Hines J.F., Khalifa M.A., Moore J.L. Fine K.P., Lage J.M., Barnes W.A.: “Recurrent granulosa cell tumor of the ovary 37 years after initial diagnosis: a case report and review of the literature”. Gynecol. Oncol., 1995, 60, 484.

[9] Hasiakos D., Papakonstantinou K., Karvouni E., Fotiou S.: “Recurrence of granulosa cell tumor 25 years after initial diagnosis. Report of a case and review of the literature”. Eur. J. Gynaecol. Oncol., 2008, 29, 86.

[10] Auranen A., Sundstrom J., Ijas J., Grenman S.: “Prognostic factors of ovarian granulosa cell tumor: a study of 35 patients and review of the literature”. Int. J. Gynecol. Cancer, 2007, 17, 1011.

[11] Vani B.R., Geethamala K., Geetha R.L., Srinivasa M.V. “Granulosa cell tumor of ovary: A clinicopathological study of four cases with brief review of literature”. J. Midlife. Health, 2014, 5, 135.

[12] Van Meurs H.S., Schuit E., Horlings H.M., van der Velden J., van Driel W.J., Mol B.W., et al.: “Development and internal validation of a prognostic model to predict recurrence free survival in patients with adult granulosa cell tumors of the ovary”. Gynecol. Oncol., 2014, 134, 498.

[13] Choan E., Samant R., Fung M.F., Le T., Hopkins L., Senterman M.: “Palliative radiotherapy for recurrent granulose cell tumor of the ovary: a report of 3 cases with radiological evidence of response”. Gynecol. Oncol., 2006, 102, 406.

[14] Gurumurthy M., Bryant A., Shanbhag S.: “Effectiveness of different treatment modalities for the management of adult-onset granulosa cell tumours of the ovary (primary and recurrent)”.Cochrane Database Syst. Rev., 2014, 4, CD006912.

[15] Freeman S.A., Modesitt S.C.: “Anastrozole therapy in recurrent ovarian adult granulose cell tumors: A report of 2 cases”. Gynecol. Oncol., 2006, 103, 755.

[16] Kyronlahti A., Kauppinen M., Lind E., Unkila-Kallio L., Butzow R., Klefstrom J., et al.: “GATA4 protects granulosa cell tumors from TRAIL-induced apoptosis”. Endocrine-Related Cancer, 2010, 17, 709.

[17] Kyronlahti A., Ramo M., Tamminen M., Unkila-Kallio L., Butzow R., Leminen A., et al.: “GATA-4 regulates Bcl-2 expression in ovarian granulosa cell tumors.” Endocrinology, 2008, 149, 5635.

[18] Heravi-Moussavi A., Anglesio M.S., Cheng S.W., Senz J., Yang W., Prentice L., et al.: “Recurrent Somatic DICER1 Mutations in Nonepithelial Ovarian Cancers”. N. Engl. J. Med. 2012, 366, 234.