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Oqbani K, Mouhoub M, Abbaoui S. Unusual presentation of adult granulosa cell tumor. A case report and review of the literature. Int Cancer Conf J 2023; 12:190-194. [PMID: 37251006 PMCID: PMC10212836 DOI: 10.1007/s13691-023-00603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/18/2023] [Indexed: 04/03/2023] Open
Abstract
Extraovarian adult granulosa cell tumor is a very uncommon neoplasm, which probably arises from the ectopic gonadal tissue along the embryonic root of the genital ridge. We report a new and rare case of an extraovarian adult granulosa cell tumor occurring in a 66-year-old woman who was presented with severe abdominal pain focused on the left iliac fossa. The immunohistopathology confirmed the diagnosis of a paratubal adult granulosa cell tumor. This paper illustrates the histogenetic origin of granulosa cell tumor, its clinicopathological and immunohistochemical features.
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Affiliation(s)
- K. Oqbani
- Department of Pathology, Faculty of Medicine, Mohammed VI University of Health Sciences, Casablanca, Morocco
- Department of Pathology, Mohammed VI University Hospital, Oujda, Morocco
| | - M. Mouhoub
- Department of Pathology, Mohammed VI University Hospital, Oujda, Morocco
| | - S. Abbaoui
- Department of Pathology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, Ibn Zohr University, Agadir, Morocco
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Erdogan O, Kilic C, Cakir C, Kilic F, Oktar O, Ersak B, Sahin M, Tokalioglu A, Kocak O, Ozturk C, Gorgulu G, Gokkaya M, Selcuk I, Korkmaz V, Comert GK, Toptas T, Ureyen I, Ucar G, Taskin S, Tasci T, Uncu D, Narin MA, Boran N, Ozdal B, Tekin OM, Ustun Y, Sancı M, Ortac F, Turan T. Is adjuvant chemotherapy necessary for 2014 FIGO stage IC adult granulosa cell tumor?: Multicentric Turkish study. Asia Pac J Clin Oncol 2023. [PMID: 37096294 DOI: 10.1111/ajco.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 04/26/2023]
Abstract
AIM The aim of our study is to examine the clinical, surgical, and pathological factors of stage 1C adult granulosa cell tumor (AGCT) patients and to investigate the effects of adjuvant therapy on recurrence and survival rates in this patient group. METHODS Out of a total of 415 AGCT patients treated by 10 tertiary oncology centers participating in the study, 63 (15.2%) patients with 2014 FIGO stage IC constituted the study group. The FIGO 2014 system was used for staging. Patient group who received adjuvant chemotherapy was compared with patient group who did not receive adjuvant chemotherapy in terms of disease-free survival (DFS), and disease-specific survival. RESULTS The 5-year DFS of the study cohort was 89%, and the 10-year DFS was 85%. Those who received adjuvant chemotherapy and those who did not were similar in terms of clinical, surgical and pathological factors, except for peritoneal cytology. In the univariate analysis, none of the clinical, surgical or pathological factors were significant for DFS. Adjuvant chemotherapy and type of treatment protocol had no impact on DFS. CONCLUSION Adjuvant chemotherapy was not associated with improved DFS and overall survival in stage IC AGCT. Multicentric and randomized controlled studies are needed for early stage AGCT in order to confirm these results and reach accurate conclusions.
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Affiliation(s)
- Ozgur Erdogan
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Cigdem Kilic
- Department of Gynecologic Oncology, Hitit University, Corum, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatih Kilic
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Okan Oktar
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Mustafa Sahin
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Alp Tokalioglu
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Ozgur Kocak
- Department of Gynecologic Oncology, Hitit University, Corum, Turkey
| | | | - Goksen Gorgulu
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Mustafa Gokkaya
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ilker Selcuk
- Department of Gynecologic Oncology, Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | | | - Tayfun Toptas
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Isin Ureyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gokhan Ucar
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Salih Taskin
- Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Tolga Tasci
- Department of Gynecologic Oncology, Bahcesehir University, Istanbul, Turkey
| | - Dogan Uncu
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Ali Narin
- Department of Gynecologic Oncology, Adana City Hospital, Adana, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Bulent Ozdal
- Department of Gynecologic Oncology, Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey
| | | | - Yaprak Ustun
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Muzaffer Sancı
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Firat Ortac
- Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
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Guleria P, Kumar L, Kumar S, Bhatla N, Ray R, Singhal S, Meena J, Mathur SR. A clinicopathological study of granulosa cell tumors of the ovary: Can morphology predict prognosis? INDIAN J PATHOL MICR 2020; 63:53-59. [PMID: 32031123 DOI: 10.4103/ijpm.ijpm_403_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective Granulosa cell tumors (GCT) are low-grade malignant sex cord-stromal tumors (SCST) with late metastasis/recurrences and long disease-free periods. We performed a clinicopathological evaluation of GCT to ascertain features having prognostic impact. Materials and Methods All cases of GCT of ovary from January 2006 to December 2018 were assessed for architectural patterns, nuclear grooves, and Call-Exner bodies. Each feature was graded on frequency of occurrence: not present (0)-very frequent (3). Anisonucleosis, necrosis, and inflammation were noted. Cases were grouped on mitotic count; <10 mitosis/10 High power field (HPF) or >=11 mitoses/10 HPF and Ki-67 index; <10% Ki-67 and >=11% Ki-67. Results GCT formed 60.1% of SCST. Sixty cases' ages were in the range of 15-78 years (median 45). Clinical details were available in 37. Commonest presentation was abnormal uterine bleeding. Serum CA125 was raised in 16.1% and Inhibin in 58.8%. Seventy percent were in stage I. Disease recurrence was associated with higher stage (P = 0.007). The most frequent pattern was diffuse sheets (47%). Call-Exner bodies were absent in 22.2%. Grooves with score 1, 2, and 3 were seen in 35.8%, 23.5%, and 13.6%, respectively. Anisonucleosis was present in 26.7%, necrosis in 11.1%, and lympho-plasmacytic infiltrate in 43%. Out of total, 93.3% had <10 mitosis/10 HPF and 43.2% had recurrence, most with high Ki-67 (P = 0.064). Conclusion Our study outlines histomorphological spectrum of GCT and emphasizes its frequent occurrence in lower stages with late recurrences. The presence of grooves may indicate granulosa-cell origin. Call-Exner bodies are not a necessity. Histomorphological features are not prognostically important. However, prognostic value of Ki-67 cannot be excluded. Limitation of the study was a small number of cases with follow-up.
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Affiliation(s)
- Prerna Guleria
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- Department of Medical Oncology, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sunesh Kumar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Ruma Ray
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Meena
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Yousif HM, Mohammed RA, Missawi HM, Elsawaf ZM, Albasri AM. Histopathological patterns of primary malignant ovarian neoplasms in different age groups in Almadinah Almunawwarah region, KSA. J Taibah Univ Med Sci 2019; 14:73-78. [PMID: 31435393 PMCID: PMC6694935 DOI: 10.1016/j.jtumed.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022] Open
Abstract
Objectives In the literature, the epidemiological pattern of ovarian neoplasms in different age groups in the Almadinah Almunawwarah region in KSA has not been completely elucidated. Moreover, an unusually frequent diagnosis of adult granulosa cell tumour (AGCT) has been observed in patients in Almadinah Almunawwarah, KSA. This study aimed to describe the pattern of ovarian neoplasms in different age groups in the Almadinah Almunawwarah region with particular emphasis on AGCT. Methods Histopathological records of all ovarian specimens diagnosed from 2011 January to 2016 December were collected from the Maternity and Children Hospital in Almaadinah Almunawwarah, KSA. Hematoxylin and eosin (HE)-stained microscopic slides of serous and mucinous epithelial borderline neoplasms and of malignant epithelial, sex cord-stromal and germ line neoplasms were identified and examined. The tissue sections from the AGCT were stained immunohistochemically with BRCA-1 antibody. Results A total of 301 ovarian specimens were obtained. Of the specimens, 217 (72%) were neoplastic and 84 (28%) were non-neoplastic. In total, 135 (63%) of the neoplastic specimens were benign, 16 (7%) were borderline tumours, and 66 (30%) were malignant tumours. Moreover, 41 (62%) of the malignant tumours were surface epithelial carcinomas, 17 (26%) were sex cord-stromal tumours, and 8 (12%) were germ cell tumours. The incidence of AGCT was unusually high, which accounts for 26% (16/66) of all malignant ovarian neoplasms. Altered BRCA-1 expression was observed in only two specimens. Conclusion In this study, malignant ovarian neoplasms accounted for 30% of all neoplastic ovarian specimens, and the incidence of AGCT was remarkable. Such tumours did not show a significantly altered expression of BRCA-1. Further studies must be conducted to explore the underlying molecular causes of this condition.
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Affiliation(s)
- Hala M Yousif
- Department of Pathology, Faculty of Medicine, Taibah University, Almadinah Almunawwarah, KSA
| | - Rabab A Mohammed
- Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hashim M Missawi
- Department of Histopathology and Cytopathology, Maternity and Children Hospital, Almadinah Almunawwarah, KSA
| | - Zeinab M Elsawaf
- Department of Pathology, Faculty of Medicine, Taibah University, Almadinah Almunawwarah, KSA
| | - Abdelkader M Albasri
- Department of Pathology, Faculty of Medicine, Taibah University, Almadinah Almunawwarah, KSA
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Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study. Gynecol Oncol 2019; 154:323-327. [DOI: 10.1016/j.ygyno.2019.05.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/26/2019] [Accepted: 05/28/2019] [Indexed: 11/22/2022]
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Puechl AM, Edwards J, Suri A, Nakayama J, Bean S, Gehrig P, Saks E, Duska L, Broadwater G, Ehrisman J, Horowitz N, Secord AA. The association between progesterone receptor expression and survival in women with adult granulosa cell tumors. Gynecol Oncol 2019; 153:74-79. [PMID: 30661765 DOI: 10.1016/j.ygyno.2019.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Granulosa cell tumors (GCT) variably express estrogen receptors (ER) and progesterone receptors (PR). The goal of this study is to evaluate the relationship between ER and PR expression patterns and clinical outcomes in women with GCT. METHODS A multicenter, retrospective analysis was performed of all cases of GCT diagnosed between 1989 and 2012. Immunohistochemical staining for ER and PR was performed on formalin-fixed paraffin embedded (FFPE) tumor tissue and interpreted using a semiquantitative scoring system that incorporated tumor cell staining proportion and intensity. Demographics, disease status, and survival information were collected. Associations between ER and PR staining scores and recurrence-free and overall survival were assessed using univariate Cox proportional hazards models. RESULTS FFPE tumor blocks were available for 149/186 GCT patients. The majority of the women had clinical stage I disease (76%). ER and PR expression was present in 52% and 98% of subjects, respectively. The median composite scores of ER and PR staining were 1 (range 0-8) and 9 (range 0-15), respectively. In univariate analysis, PR composite score >9 was strongly associated with decreased recurrence-free survival (HR = 2.9, 95% CI = 1.5-5.5) and decreased overall survival (HR = 3.7, CI 1.3-10.2). ER composite score was not a significant predictor of recurrence-free survival or overall survival (p = 0.7, HR = 1.1, 95% CI 0.6-2.0 and p = 0.06, HR = 1.1, 95% CI 0.4-2.9, respectively). CONCLUSIONS Our results reveal that high PR composite score (≥9) was associated with both decreased recurrence-free and overall survival in patients with GCT while ER expression was not associated with survival outcomes.
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Affiliation(s)
- Allison M Puechl
- Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, United States of America.
| | - James Edwards
- WakeMed Health and Hospitals, Raleigh, NC, United States of America
| | - Anuj Suri
- Houston Methodist Gynecologic Oncology Associates, Houston, TX, United States of America
| | - John Nakayama
- Univerity Hospitals, Cleveland, OH, United States of America
| | - Sarah Bean
- Duke University, Department of Pathology, Durham, NC, United States of America
| | - Paola Gehrig
- University of North Carolina at Chapel Hill Division of Gynecologic Oncology, Chapel Hill, NC, United States of America
| | - Erin Saks
- Carilion Clinic, Roanoke, VA, United States of America
| | - Linda Duska
- University of Virginia, Division of Gynecologic Oncology, United States of America
| | - Gloria Broadwater
- Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, United States of America
| | - Jessie Ehrisman
- Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, United States of America
| | - Neil Horowitz
- Brigham and Women's Hospital, Division of Gynecologic Oncology, United States of America
| | - Angeles Alvarez Secord
- Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, United States of America
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Wang WC, Lee YT, Lai YC. PMS2 gene mutation results in DNA mismatch repair system failure in a case of adult granulosa cell tumor. J Ovarian Res 2017; 10:22. [PMID: 28347324 PMCID: PMC5369012 DOI: 10.1186/s13048-017-0317-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/22/2017] [Indexed: 12/19/2022] Open
Abstract
Background Granulosa cell tumors are rare ovarian malignancies. Their characteristics include unpredictable indolent growth with malignant potential and late recurrence. Approximately 95% are of adult type. Recent molecular studies have characterized the FOXL2 402C > G mutation in adult granulosa cell tumor. Our previous case report showed that unique FOXL2 402C > G mutation and defective DNA mismatch repair system are associated with the development of adult granulosa cell tumor. Findings In this study, the DNA sequences of four genes, MSH2, MLH1, MSH6, and PMS2, in the DNA mismatch repair system were determined via direct sequencing to elucidate the exact mechanism for the development of this granulosa cell tumor. The results showed that two missense germline mutations, T485K and N775L, inactivate the PMS2 gene. Conclusions The results of this case study indicated that although FOXL2 402C > G mutation determines the development of granulosa cell tumor, PMS2 mutation may be the initial driver of carcinogenesis. Immunohistochemistry-based tumor testing for mismatch repair gene expression may be necessary for granulosa cell tumors to determine their malignant potential or if they are part of Lynch syndrome.
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Affiliation(s)
- Wen-Chung Wang
- Department of Obstetrics and Gynecology, Jen-Ai Hospital, Taichung, Taiwan
| | - Ya-Ting Lee
- Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, No.110, Sec. 1, Chien Kuo N. Road, Taichung, 402, Taiwan, Republic of China
| | - Yen-Chein Lai
- Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, No.110, Sec. 1, Chien Kuo N. Road, Taichung, 402, Taiwan, Republic of China.
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Noninvasive test for the diagnosis of ovarian hormone-secreting-neoplasm in postmenopausal women. Gynecol Oncol Rep 2016; 15:12-5. [PMID: 26937480 PMCID: PMC4750012 DOI: 10.1016/j.gore.2015.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 06/04/2015] [Accepted: 06/07/2015] [Indexed: 12/03/2022] Open
Abstract
Context The diagnosis of ovarian hormone-secreting neoplasm in postmenopausal women is currently based on imaging modalities and selective venography. However, these diagnostic tests are not always accurate. In order to improve and simplify the diagnosis, we propose a noninvasive hormonal test. Objective To report our experience using noninvasive hormonal test for the diagnosis of ovarian hormone producing tumor in two postmenopausal women. Design and intervention Evaluation of androgen and estradiol serum levels following 1. Adrenal hormonal depression, 2. ovarian hormonal depression and 3. ovarian hormonal stimulation. Setting Tertiary care medical center. Main outcome measures Changes in androgen and estradiol levels. Results In the first case, total testosterone, free androgen index and estradiol serum levels decreased following ovarian depression by GnRH-antagonist (6.9 nmol/L, 67 nmol/L and < 70 pmol/L, respectively) and subsequently increased after ovarian stimulation with LH (11.5 nmol/L, 117 nmol/L and 176 pmol/L, respectively). Histological evaluation revealed steroid cell tumor in one ovary. In the second case, estradiol serum levels decreased following ovarian depression by GnRH-antagonist (73 pmol/L) and subsequently increased following ovarian stimulation with FSH (118 pmol/L). Histological evaluation revealed granulosa cell tumor in one ovary. Conclusions To our knowledge, these are the first cases of ovarian hormone-producing tumors in postmenopausal women diagnosed by noninvasive hormonal test. The proposed test can be considered in postmenopausal women suspected of having androgen and/or estrogen producing tumors. A noninvasive test for diagnosing postmenopausal hormone-producing ovarian tumors Hormonal levels following adrenal depression, ovarian depression and stimulation Changes in hormone levels indicate the presence of ovarian producing tumors.
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Mebes I, Graf M, Kellner M, Keck C, Segerer SE. High Estradiol Levels During Postmenopause - Pitfalls in Laboratory Analysis. Geburtshilfe Frauenheilkd 2015; 75:941-944. [PMID: 26500371 DOI: 10.1055/s-0035-1557815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A 54-year-old woman was admitted with a result of high serum estradiol levels (> 4300 pg/ml) and typical postmenopausal symptoms. She had a history of an adnexectomy (normal histopathology) due to the elevated estradiol levels. After surgery, estradiol levels were as high as before. Analyzing the anti-mullerian hormone (AMH), inhibin B, DHEA-S and estrone, typical postmenopausal levels were found. Serum estradiol levels were controlled several times with rabbit-derived polyclonal as well as monoclonal antibodies to optimize the selectivity of the test system. Secondary, a radioimmunoassay was performed to exclude interferences of the detection system where lower, but still elevated estradiol levels (186 pg/ml) were found. Hypothesizing that our patient underwent a cross reaction with irregular antibodies, a control was done using sheep-derived antibodies, which proved a postmenopausal hormone level (estradiol level < 5 pg/ml). This result was confirmed using a fluorescence enzyme immunoassay (FEIA) revealing high levels of irregular antibodies (> 200 mg/l; reference < 30 mg/l). This case depicts the pitfalls of estradiol measurement detecting false elevated estradiol levels in a postmenopausal woman.
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Affiliation(s)
- I Mebes
- Endokrinologikum Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Reproduktionsmedizin und Pränatale Medizin, Hamburg
| | - M Graf
- Endokrinologikum Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Reproduktionsmedizin und Pränatale Medizin, Hamburg
| | - M Kellner
- Endokrinologikum Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Reproduktionsmedizin und Pränatale Medizin, Hamburg
| | - C Keck
- Endokrinologikum Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Reproduktionsmedizin und Pränatale Medizin, Hamburg
| | - S E Segerer
- Endokrinologikum Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Reproduktionsmedizin und Pränatale Medizin, Hamburg
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Wang PH, Sun HD, Lin H, Wang KL, Liou WS, Hung YC, Chiang YC, Lu CH, Lai HC, Chang TC. Outcome of patients with recurrent adult-type granulosa cell tumors – A Taiwanese Gynecologic Oncology Group study. Taiwan J Obstet Gynecol 2015; 54:253-9. [DOI: 10.1016/j.tjog.2014.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 12/30/2022] Open
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Iavazzo C, Gkegkes ID, Vrachnis N. Fertility sparing management and pregnancy in patients with granulosa cell tumour of the ovaries. J OBSTET GYNAECOL 2014; 35:331-5. [PMID: 25383508 DOI: 10.3109/01443615.2014.968107] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Granulosa cell tumours (GCTs) of the ovary are a rare entity among the neoplasms of gynaecological oncology. Deriving from the stroma of the ovary, GCTs are generally characterised by insidious growth, low malignancy potential and late recurrence. The standard treatment for these tumours is principally surgical, consisting of bilateral adnexectomy and hysterectomy. This is a narrative review of the current literature regarding the role of fertility sparing surgery in ovarian granulosa tumour. In the included studies, fertility sparing surgery was performed in 171 out of 350 patients. Recurrence rates ranged between 9.8-27.4%. Out of 131 patients, 15 achieved pregnancy. The data were limited regarding completion post-pregnancy surgery. Due to the fact that GCTs often affect younger ages, of crucial importance is the preservation of fertility by conserving the uterus and the contralateral ovary, while close monitoring is essential in order to achieve early identification and treatment of a possible recurrence. After completion of family planning, hysterectomy and salpingo-oophorectomy are recommended.
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Affiliation(s)
- C Iavazzo
- IASO Maternity Hospital , Athens , Greece
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13
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A Comprehensive Review of Diagnostic and Treatment Options for Granulosa Cell Tumors of the Ovary. Obstet Gynecol Surv 2014; 69:29-38. [DOI: 10.1097/ogx.0000000000000010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Suri A, Carter EB, Horowitz N, Denslow S, Gehrig PA. Factors associated with an increased risk of recurrence in women with ovarian granulosa cell tumors. Gynecol Oncol 2013; 131:321-4. [DOI: 10.1016/j.ygyno.2013.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 08/14/2013] [Accepted: 08/15/2013] [Indexed: 12/31/2022]
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Hammer A, Lauszus FF, Petersen AC. Ovarian granulosa cell tumor and increased risk of breast cancer. Acta Obstet Gynecol Scand 2013; 92:1422-5. [PMID: 24283356 DOI: 10.1111/aogs.12252] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 08/29/2013] [Indexed: 12/01/2022]
Abstract
Granulosa cell tumor of the ovary (GCT) is a rare neoplasm. The tumor often secretes estrogens and then presents at an earlier stage due to hormone-related symptoms. GCT women are at increased risk of endometrial carcinoma, but there is only limited information about GCTs and potential association to other hormone-related neoplasms such as breast cancer. We conducted a retrospective follow-up study on 163 women with GCT. Medical records and histological sections were reviewed and a search in the pathology registry performed. Eight [95% confidence interval (CI); 3.4-15.8] GCT women were diagnosed with a breast neoplasm; one with Paget's disease of the nipple and seven with breast carcinoma. Based on calculations using incidence rates on breast cancer among Danish women, we would have expected 2.5 cases of breast cancer. The odds ratio was 3.3 (95% CI, 1.6-6.6), suggesting an increased risk of breast cancer in GCT women.
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Affiliation(s)
- Anne Hammer
- Department of Obstetrics and Gynecology, Herning Hospital, Herning, Denmark
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Anti-VEGFA Therapy Reduces Tumor Growth and Extends Survival in a Murine Model of Ovarian Granulosa Cell Tumor. Transl Oncol 2013; 6:226-33. [PMID: 23730402 DOI: 10.1593/tlo.13136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 02/19/2013] [Accepted: 02/21/2013] [Indexed: 12/12/2022] Open
Abstract
Although angiogenesis has been proposed as a therapeutic target for the treatment of ovarian granulosa cell tumor (GCT), its potential has not been evaluated in controlled studies. To do so, we used the Pten (tm1Hwu/tm1Hwu); Ctnnb1 (tm1Mmt/+);Amhr2 (tm3(cre)Bhr/+) (PCA) mouse model, which develops GCTs that mimic the advanced disease in women. A monoclonal anti-vascular endothelial growth factor A (VEGFA) antibody was administered weekly to PCA mice beginning at 3 weeks of age. By 6 weeks of age, anti-VEGFA therapy significantly decreased tumor weights relative to controls (P < .05) and increased survival, with all treated animals but none of the controls surviving to 8 weeks of age. Analyses of PCA tumors showed that anti-VEGFA treatment resulted in significant decreases in tumor cell proliferation and microvessel density relative to controls (P < .05). However, treatment did not have a significant effect on apoptosis or tumor necrosis. The VEGFA receptor 2 (VEGFR2) signaling effector p44/p42 mitogen-activated protein kinase (MAPK), whose activity is associated with cell proliferation, was significantly less phosphorylated (i.e., activated) in tumors from the treated group (P < .05). Conversely, no significant difference was found in the activation of protein kinase B, a VEGFR2 signaling effector associated with cell survival. Together, these results suggest that anti-VEGFA therapy is effective at inhibiting GCT growth in the PCA model and acts by reducing microvascular density and cell proliferation through inhibition of the VEGFR2-MAPK pathway. Findings from this preclinical model therefore support the investigation of targeting VEGFA for the adjuvant treatment of GCT in women.
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Park JY, Jin KL, Kim DY, Kim JH, Kim YM, Kim KR, Kim YT, Nam JH. Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary. Gynecol Oncol 2012; 125:80-6. [DOI: 10.1016/j.ygyno.2011.12.442] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 12/16/2011] [Accepted: 12/17/2011] [Indexed: 11/26/2022]
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KITAHARA G, NAMBO Y, EL-SHEIKH ALI H, KAJISA M, TANI M, NIBE K, KAMIMURA S. Anti-Müllerian Hormone Profiles as a Novel Biomarker to Diagnose Granulosa-theca Cell Tumors in Cattle. J Reprod Dev 2012; 58:98-104. [DOI: 10.1262/jrd.11-101t] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Go KITAHARA
- Laboratory of Theriogenology, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Yasuo NAMBO
- Hidaka Training and Research Center, Japan Racing Association, Hokkaido 057-0171, Japan
| | - Hossam EL-SHEIKH ALI
- Laboratory of Theriogenology, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan
- Theriogenology Department, Faculty of Veterinary Medicine, University of Mansoura, Mansoura 35516, Egypt
| | - Makoto KAJISA
- Soo Agricultural Mutual Aide Association, Kagoshima 899-7601, Japan
| | - Mineto TANI
- Laboratory of Large Animal Theriogenology, Faculty of Agriculture, University of Tokai, Kumamoto 869-1404, Japan
| | - Kazumi NIBE
- Japan Animal Referral Medical Center, Kanagawa 213-0032, Japan
| | - Shunichi KAMIMURA
- Laboratory of Theriogenology, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan
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