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Nerune SM, Das SK, Pawar M. Adult granulosa cell tumour camouflaged as mucinous neoplasm. BMJ Case Rep 2024; 17:e259788. [PMID: 39013625 DOI: 10.1136/bcr-2024-259788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
This case report delves into the diagnostic intricacies and clinical management of adult granulosa cell tumour (AGCT) in a woman in her 50s, presenting with pain abdomen. Initial imaging investigations like ultrasound suggested diagnosis of benign cystadenoma. Further MRI revealed a large well-defined multiloculated lesion so a diagnosis of neoplastic aetiology/likely mucinous cystadenocarcinoma was offered. However, the definitive diagnosis was established through meticulous histopathological examination, revealing characteristic features of AGCT, a rare ovarian neoplasm. The case underscores the diagnostic challenges posed by AGCT, the importance of integrating clinical, radiological and histopathological data, and the necessity for a multidisciplinary approach for accurate diagnosis and optimal patient management.
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Affiliation(s)
- Savitri M Nerune
- Pathology, Shri B.M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, Karnataka, India
| | - Sayandeep K Das
- Pathology, Shri B.M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, Karnataka, India
| | - Monika Pawar
- Pathology, Shri B.M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, Karnataka, India
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2
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Bin Naeem S, Imran M, Abbas M, Majeed MA, Jamil MA, Samreen M, Siddiqui N. Story of 20 Years of Triumph: A Case Report of Two Patients With Stage IV Granulosa Cell Tumor of the Ovary. Cureus 2024; 16:e57615. [PMID: 38707031 PMCID: PMC11069410 DOI: 10.7759/cureus.57615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Ovarian granulosa cell tumors (GCTs) are rare neoplasms with a unique incidence pattern peaking in postmenopausal women. This case report presents two instances of stage 4 recurrent adult GCTs with a prolonged 20-year follow-up. Patient 1, diagnosed at 54 years, experienced multiple recurrences managed through surgery, hormonal therapy, and chemotherapy, culminating in hepatocellular carcinoma. Patient 2, diagnosed at 67 years, underwent various treatments, including surgery, chemotherapy, and hormonal therapy, demonstrating disease stability. Despite the generally favorable prognosis, these cases highlight the challenges of managing recurrent GCTs, emphasizing the need for tailored therapeutic approaches.
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Affiliation(s)
- Sameen Bin Naeem
- Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Maryam Imran
- Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Mansoor Abbas
- Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | | | - Muhammad Ahsan Jamil
- Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Mahnoor Samreen
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Neelam Siddiqui
- Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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Moro F, Giudice MT, Bolomini G, Moruzzi MC, Mascilini F, Quagliozzi L, Ciccarone F, Scambia G, Fagotti A, Valentin L, Testa AC. Imaging in gynecological disease (27): clinical and ultrasound characteristics of recurrent ovarian stromal cell tumors. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 63:399-407. [PMID: 37774092 DOI: 10.1002/uog.27504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of recurrent granulosa cell and Sertoli-Leydig cell tumors. METHODS This was a retrospective observational study performed at Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Rome (Gemelli center), Italy. Patients with a histological diagnosis of recurrent granulosa cell tumor or Sertoli-Leydig cell tumor were identified from the database of the Department of Gynecological Oncology. Those who had undergone a preoperative ultrasound examination at the Gemelli center between 2012 and 2020 were included, and the data retrieved from the original ultrasound reports. In all of these reports, the recurrent tumors were described using International Ovarian Tumor Analysis (IOTA) terminology. If a patient had more than one episode of relapse, information from all episodes was collected. If there was more than one recurrent tumor at the same ultrasound examination, all tumors were included. One expert sonographer also reviewed all available ultrasound images to identify typical ultrasound patterns using pattern recognition. RESULTS We identified 30 patients with a histological diagnosis of recurrent granulosa cell tumor (25 patients, 55 tumors) or Sertoli-Leydig cell tumor (five patients, seven tumors). All 30 had undergone at least one preoperative ultrasound examination at the Gemelli center and were included. These women had a total of 66 episodes of relapse, of which a preoperative ultrasound examination had been performed at the Gemelli center in 34, revealing 62 recurrent lesions: one in 22/34 (64.7%) episodes of relapse, two in 4/34 (11.8%) episodes and three or more in 8/34 (23.5%) episodes. Most recurrent granulosa cell tumors (38/55, 69.1%) and recurrent Sertoli-Leydig tumors (6/7, 85.7%) were classified as solid or multilocular-solid tumors, while 8/55 (14.5%) recurrent granulosa cell tumors and 1/7 (14.3%) recurrent Sertoli-Leydig cell tumors were unilocular cysts and 9/55 (16.4%) recurrent granulosa cell tumors were multilocular cysts. The nine unilocular cysts had contents that were anechoic (n = 2) or had low-level echogenicity (n = 7), had either smooth (n = 4) or irregular (n = 5) internal cyst walls, and ranged in largest diameter from 8 to 38 mm, with three being < 20 mm and five being 20-30 mm. On retrospective review of the images, two typical ultrasound patterns were described: small solid tumor measuring < 2 cm (15/62, 24.2%) and tumor with vascularized echogenic ground-glass-like content (12/62, 19.4%). CONCLUSIONS Some granulosa cell and Sertoli-Leydig cell recurrences manifest one of two typical ultrasound patterns, while some appear as unilocular cysts. These are usually classified as benign, but in patients being followed up for a granulosa cell tumor or Sertoli-Leydig cell tumor, a unilocular cyst should be considered suspicious of recurrence. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - M T Giudice
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - G Bolomini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - M C Moruzzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - F Mascilini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - L Quagliozzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - F Ciccarone
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Valentin
- Skåne University Hospital Malmö, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Zhang Y, Zhang Z, Ding X, Zhang K, Dai Y, Cheng W, Luo C. Identification of prognostic factors and construction of nomogram to predict cancer-specific survival for patients with ovarian granulosa cell tumors. Cancer Rep (Hoboken) 2024; 7:e2046. [PMID: 38507268 PMCID: PMC10953832 DOI: 10.1002/cnr2.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Ovarian granulosa cell tumors (OGCTs) feature low incidence, indolent growth and late recurrence. Treatment for recurrent OGCTs is challenging. METHODS The present study was designed to explore the prognostic factors and establish a nomogram to predict cancer-specific survival (CSS) for OGCTs patients. Enrolled in the study were 1459 eligible patients in the Surveillance, Epidemiology, and End Results (SEER) database, who were randomized to the training (n = 1021) or testing set (n = 438) at a ratio of 7:3. Univariate and multivariate Cox regression analyses were employed to screen the prognostic factors. The predictors were determined by using the Least absolute shrinkage and selection operator (LASSO) regression analysis. The model was constructed via the Cox proportional hazards risk regression analysis. The performance and clinical value of the nomograms was assessed with C-index, calibration plots, and decision curve analysis. RESULTS Age, pTNM stage, tumor size, surgery of the primary tumor, surgery of regional lymph nodes (LNs), residual disease after surgery, and chemotherapy were considered as significant predictive factors for CSS in OGCTs patients. After screening, the prognostic factors except surgery of regional LNs and chemotherapy were employed to build the nomogram. With desirable discrimination and calibration, the nomogram was more powerful in predicting CSS than the American Joint Committee on Cancer staging system in clinical use. CONCLUSION This novel prognostic nomogram, which comprises a stationary nomogram and a web-based calculator, offers convenience for clinicians in personalized decision-making including optimal treatment plans and prognosis assessments for OGCTs patients.
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Affiliation(s)
- Yue Zhang
- Department of GynecologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Zhen Zhang
- Department of GynecologySuqian First HospitalSuqianChina
| | - Xinyao Ding
- Department of GynecologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Keyi Zhang
- Department of GynecologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Youren Dai
- Department of GynecologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Wenjun Cheng
- Department of GynecologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Chengyan Luo
- Department of GynecologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
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da Costa REAR, Silva MCA, Cavalcante ECX, Branco RDOC, dos Reis CA, Vieira SC. Granulosa cell tumor of the ovary: a series of 6 cases. Pan Afr Med J 2024; 47:58. [PMID: 38646138 PMCID: PMC11032080 DOI: 10.11604/pamj.2024.47.58.38324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/05/2024] [Indexed: 04/23/2024] Open
Abstract
Granulosa cell tumor (GCT) is a rare ovarian malignancy that represents only 2-3% of all cases. There are two subtypes of GCT: juvenile/JGCT (5% of cases) and adult/AGCT (95% of cases). This study aimed to describe a series of 6 GCT cases. The 6 study patients were managed from June 2011 to November 2022 in a private oncology clinic located in Teresina (PI), Brazil. At diagnosis, the mean patient age was 47 years, and symptoms in 5 patients (83%) were pelvic pain and/or increased abdominal volume. The majority of the patients (N=4/67%) had no comorbidities or findings related to GCT on physical examination. The mean tumor size was 11 cm. Five (83%) tumors were stage Ia and one tumor (17%) was stage III. Regarding tumor subtype, 5 (83%) were AGCT and 1 (17%) was JGCT. Surgical treatment consisted of unilateral salpingo-ophorectomy in 2 patients (33%), total hysterectomy and bilateral salpingo-ophorectomy in 3 patients (50%), and cytoreduction (suboptimal) in 1 patient (17%). After a mean follow-up period of 62.7 months, 5 patients (83%) are still alive and free of disease. One (17%) died from disease progression after 126 months. In the current study, disease-free overall survival was 83%, in a mean follow-up period of 62.7 months.
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Yumru Celiksoy H, Dickie C, Seckl MJ, Aydın E, Sozen H, Topuz S, Fotopoulou C. Effectiveness of adjuvant systemic therapy following complete cytoreductive surgery in patients with recurrent granulosa cell tumours of the ovary. Sci Rep 2024; 14:993. [PMID: 38200105 PMCID: PMC10781791 DOI: 10.1038/s41598-024-51752-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/09/2024] [Indexed: 01/12/2024] Open
Abstract
Aim of the present analysis is to compare the impact of antihormonal therapy versus cytotoxic chemotherapy versus a watch a wait approach on disease-free survival (DFS) in the adjuvant setting of patients who underwent complete cytoreductive surgery(CRS) for recurrent adult type granulosa cell tumours of the ovary (GCT). Moreover, we wished to identify prognostic risk factors for recurrence. We included recurrent GCT-patients who underwent CRS resulting in total macroscopic tumour clearance, treated in two gynaecological cancer centres over a 20-year period (2000-2020). CRS was performed for 51 recurrences in 26 GCT-patients. Adjuvant systemic treatments were as follows: chemotherapy in 21 cases, hormonotherapy in 10 cases, no systemic treatment in 20 cases. There were no statistically significant differences in DFS between chemotherapy, hormonotherapy and no systemic treatment: median DFS was 57, 36 and 57 months, respectively (p = 0.616). Extra-pelvic and/or multifocal tumour dissemination were found to be independent predictive factors for subsequent recurrences. In the cases with both lower and upper abdominal involvement (n = 18), patients who received chemotherapy (n = 9) had longer DFS than those who had hormonotherapy (n = 2) or no adjuvant therapy (n = 7) at all: median DFS was 36, 13 and 15 months, respectively (p = 0.9). Our findings do not encourage the administration of adjuvant therapy following complete CRS for GCT-relapse. Selected high-risk patients with disseminated disease may derive clinical benefit from additional chemotherapy, larger-scale multicentre studies are warranted to define treatment algorithms for this rare disease.
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Affiliation(s)
- Harika Yumru Celiksoy
- Department of Gynaecologic Oncology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
| | - Catriona Dickie
- Department of Gynaecologic Oncology, Imperial College London Faculty of Medicine, London, UK
| | - Michael J Seckl
- Department of Medical Oncology, Imperial College London Faculty of Medicine, London, UK
| | - Esra Aydın
- Department of Medical Oncology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Hamdullah Sozen
- Department of Gynaecologic Oncology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Samet Topuz
- Department of Gynaecologic Oncology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Christina Fotopoulou
- Department of Gynaecologic Oncology, Imperial College London Faculty of Medicine, London, UK
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Simovic N, Djuric P, Stojsic J, Dimkovic N, Naumovic R. An unusual cause of rapidly progressive glomerulonephritis associated with ANCA vasculitis and ovarian malignancy - a relapse 39 years after initial treatment. Cent Eur J Immunol 2023; 48:163-166. [PMID: 37692031 PMCID: PMC10485690 DOI: 10.5114/ceji.2023.127744] [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: 09/22/2022] [Accepted: 04/26/2023] [Indexed: 09/12/2023] Open
Abstract
A 69-year-old woman presented with severe anemia, proteinuria, microscopic hematuria and rapidly progressive renal failure. She was admitted to the nephrology department due to severe deterioration of renal function with complaints of malaise, fever, dry cough and occasional epistaxis that appeared 2 months prior to admission. Histopathologic examination of a specimen from kidney biopsy and immunologic findings revealed ANCA positive pauci-immune crescentic glomerulonephritis. The patient had a history of ovarian granulosa cell tumor and lung metastases that were treated surgically with postoperative radiotherapy and chemotherapy. Thoracic computed tomography showed tissue neoplasm in the right lung and ultrasound-guided percutaneous transthoracic biopsy confirmed granulosa cell tumor. That was a relapse, thirty-nine years after initial treatment of malignant disease and twenty-four years after surgical resection of metastases from both lungs. Although the association between malignancy and vasculitis has been well known for decades, this is the first described case of ANCA vasculitis associated with any type of gynecological malignancy and glomerulonephritis.
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Affiliation(s)
- Nikola Simovic
- Department of Nephrology and Hemodialysis, Zvezdara University Medical Center, Belgrade, Serbia
| | - Petar Djuric
- Department of Nephrology and Hemodialysis, Zvezdara University Medical Center, Belgrade, Serbia
- School of Medicine, University of Belgrade, Serbia
| | - Jelena Stojsic
- Department of Histopathology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Radomir Naumovic
- Department of Nephrology and Hemodialysis, Zvezdara University Medical Center, Belgrade, Serbia
- School of Medicine, University of Belgrade, Serbia
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Xia L, Qiu S, Kong FB, Lai J, Huang H, Hu H, Liu X, Ye Z, Cao J. Epidemiology and Nomogram for Predicting the Cancer-specific Survival of Ovarian Granulosa Cell Tumor: A Seer database study. J Gynecol Obstet Hum Reprod 2023; 52:102601. [PMID: 37156420 DOI: 10.1016/j.jogoh.2023.102601] [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: 02/06/2023] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE ovarian granulosa cell tumor (OGCT) is a kind of infrequent ovarian malignant tumor with limited epidemiological data available. we established a predictive nomograph to verify the clinical prognosis. METHODS 1005 diagnosed with ovarian granulosa cell tumor (OGCT) were extracted from Surveillance, Epidemiology, and End Results (SEER) public database from 2000-2018. Kaplan-Meier analysis was applied to distinguish risk factors, univariate and multivariate Cox analyses were used to determine the independent prognostic factors for cancer-specific survival (CSS) of OGCT patients. The obtained prognostic variables were combined to construct a nomogram model for predicting CSS in OGCT patients. RESULTS Model performance was detected and evaluated with ROC curves and calibration plots. Data collected from 1005 patients were divided into two groups: training cohort(n=703,70%) and validation cohort(n=302,30%). The multivariate Cox model identified five covariates including age, marital status, AJCC stages, surgery and chemotherapy as independent interfering factors of CSS. The nomogram has shown a promising and excellent accuracy in evaluating 3 -, 5 -, 8-year CSS in OGCT patients. In terms of the CSS of the training cohort, the AUC values of the 3 -, 5 -, 8-year ROC curves were 0.819,0.8,0.819, while in terms of the CSS of the validation cohort, the AUC values of the validation cohort were 0.822,0.84,0.823, respectively. All the calibration curves showed pleasant consistency between predicted and actual survival rates. The nomogram model established in the study can improve the veracity of prognosis prediction, thereby improving the accuracy of individualized survival risk assessment, and providing targeted and constructive recommendations for specific treatment options. CONCLUSION Age, advanced clinical stage, widower and without surgery therapy are independent risk factors for poor prognosis and the nomogram we constructed can help clinicians efficiently recognize high-risk OGCT patients to guide targeted therapies and improve their outcomes.
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Affiliation(s)
- Longjie Xia
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Shenghui Qiu
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Fan-Biao Kong
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of Colorectal and Anal Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, Guangxi Zhuang autonomous region 530021, People's Republic of China.; Institute of Minimally Invasive Technology and Applications Guangxi Academy of Medical Science,6 Taoyuan Road, Nanning, Guangxi Zhuang autonomous region 530021, People's Republic of China
| | - Jianqin Lai
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Huixian Huang
- Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China
| | - Huiqiong Hu
- Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Xiangxia Liu
- Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN, USA 38138..
| | - Zi Ye
- Department of Emergency, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Jie Cao
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China.
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Gu Y, Wang D, Jia C, Chen L, Cang W, Wan X, Yang J, Xiang Y. Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients. Acta Obstet Gynecol Scand 2023; 102:782-790. [PMID: 37012211 DOI: 10.1111/aogs.14558] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/15/2023] [Accepted: 03/03/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION This study aimed to describe the clinicopathological characteristics of recurrent adult granulosa cell tumor and identify the risk factors for recurrence. MATERIAL AND METHODS Seventy recurrent adult granulosa cell tumor patients treated in Peking Union Medical College Hospital between 2000 and 2020 were retrospectively reviewed. The primary outcomes were progression-free survival after first recurrence (PFS-R), overall survival after first recurrence (OS-R) and recurrence frequency. The Kaplan-Meier analysis, univariate and multivariate Cox proportional hazard analysis, and the Prentice, Williams and Peterson counting process (PWP-CP) model were adopted. RESULTS There were 70 patients included in the study, and recurrence occurred twice in more than 71% of patients, and 49.9% of patients relapsed ≥ three times. The recurrence pattern in over half of the patients at first recurrence was multifocal and distant disease, and abdominal or pelvic mass and liver metastasis were the most common. The 5-year PFS-R was 29.3%, and the 10-year PFS-R was 11.3%; the 5-year OS-R was 94.9%, and the 10-year OS-R was 87.9%. Kaplan-Meier analysis demonstrated that patients with distant recurrence and PFS1 (PFS when first recurrence occurred) ≤60 months had worse PFS-R (p = 0.017, 0.018), and patients with PFS-R ≤ 34 months had worse OS-R (p = 0.023). It demonstrated that PFS1 ≤ 60 months (hazard ratio, HR 1.9, 95% confidence interval [CI]: 1.1-3.4, p = 0.028) was an independent risk factor for PFS-R, and local lesion at recurrence (HR 0.488, 95% CI: 0.3-0.9, p = 0.027) was an independent protective factor for PFS-R. In addition, it demonstrated that PFS-R ≤ 33 months (HR 5.5, 95% CI: 1.2-25.3, p = 0.028) was an independent risk factor for OS-R. The PWP-CP analysis showed that laparoscopic operation (at each operation) could significantly increase recurrence times (p = 0.002, HR = 3.4), and no existence of gross residual lesion (R0) at each recurrence operation could significantly decrease recurrence frequency (p < 0.001, HR <0.001). CONCLUSIONS The recurrence pattern in patients with recurrent adult granulosa cell tumor was characterized as late and repeated, multifocal, and distant relapse. It has been demonstrated that PFS1 ≤ 60 months and distant lesion at recurrence are independent risk factors for PFS-R, and PFS-R ≤ 33 months is an independent risk factor for OS-R. The PWP-CP model showed that the transabdominal approach and surgery reaching R0 could significantly decrease the recurrence frequency.
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Affiliation(s)
- Yu Gu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Congwei Jia
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lihua Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Wei Cang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Xirun Wan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Junjun Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
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Liu R, Ye L, Yan J, Cao Y, Huang S, Qian Z, Qian T. Transition of ovarian granulosa cell tumor from a solid mass to a cystic mass in two months on MR imaging in an adult woman: A case report. Radiol Case Rep 2023; 18:397-401. [DOI: 10.1016/j.radcr.2022.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022] Open
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Zhuang Y, Yang H. The Prognostic Significance of Adjuvant Chemotherapy in Adult Ovarian Granulosa Cell Tumors: A Systematic Review and Meta-analysis. Cancer Control 2023; 30:10732748231215165. [PMID: 37957122 PMCID: PMC10644757 DOI: 10.1177/10732748231215165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/01/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the oncological and prognostic significance of adjuvant chemotherapy (CT) in patients with adult granulosa cell tumors of the ovary (AOGCT). METHODS We searched the Chinese National Knowledge Infrastructure, Clinical Trials, Wanfang Database, Web of Science, Cochrane Library, and MEDLINE electronic databases for articles published up to May 2023. Reference lists of the enrolled studies, Google Scholar, and scientific meeting reports were also manually searched. RESULTS We enrolled 5641 patients with AOGCT from 33 eligible studies, including 1674 (29.7%) and 3967 (70.3%) patients in the CT and non-CT groups, respectively. Based on the cumulative results, adjuvant CT did not affect the risk of recurrence or progression (R/P) (odds ratio [OR]: 1.67, 95% confidence interval [CI]: 1.01-2.78, I2 = 63%, P = .05) and 5-year overall survival (OR: .86, 95% CI: .70-1.04, I2 = 0%, P = .12) of patients with AOGCT. However, adjuvant CT might reduce the 5-year disease-free survival (OR: 2.90, 95% CI: 1.19-7.08, I2 = 55%, P = .02). Sub-group analysis revealed that adjuvant CT did not affect the risk of R/P in patients with early-stage AOGCT (OR: .78, 95% CI: .43-1.43, I2 = 2%, P = .43) and advanced or recurrent AOGCT (OR: .78, 95% CI: .43-1.43, I2 = 2%, P = .43). CONCLUSION This meta-analysis suggests that patients with AOGCT might not benefit from adjuvant CT, even those with advanced or recurrent disease. The results should be interpreted with caution because of the inherent limitations of retrospective studies.
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Affiliation(s)
- Yuan Zhuang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Hua Yang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
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Zhang J, Zhang Y, Guo Y. Combination of clinical and MRI features in diagnosing ovarian granulosa cell tumor: A comparison with other ovarian sex cord-gonadal stromal tumors. Eur J Radiol 2023; 158:110593. [PMID: 36434968 DOI: 10.1016/j.ejrad.2022.110593] [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: 06/29/2022] [Revised: 10/09/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the combination of magnetic resonance imaging (MRI) findings and clinical features in diagnosing ovarian granulosa cell tumor (OGCT) and comparing OGCTs with other ovarian sex cord-gonadal stromal tumors (OSGTs). METHODS Women who underwent MRI and were surgically confirmed with OSGTs between January 2015 and January 2022 were included in the study. Histology was used as a primary method of diagnosis. T1WI, T2WI, and DWI MR scans were performed for all patients. All MR images were reviewed by two radiologists. The clinic baseline characteristics of all patients were recorded. RESULTS A total of 58 patients were enrolled, with 21 OGCTs found in 20 patients and 39 other OSGTs found in 38 patients. In terms of clinical, the proportion of vaginal discharge/bleeding and menstrual abnormalities were significantly higher in OGCTs than in the control group. A multivariate analysis of the combined clinical MRI revealed that symptomatic, T2 signals of the solid component, Honeycomb-sign, Swiss cheese-sign, and ADC values were independent features for discriminating between OGCTs and other OSGTs. Clinical features, MRI features, and a combined model were established; the areas under the curve of the three models in predicting OGCTs and other OSGTs were 0.694, 0.852, and 0.927, respectively. The DeLong test showed that the combined model had the highest efficiency in predicting OGCTs (p < 0.05), which was significantly different from the AUC of the other two models (p < 0.05). CONCLUSIONS Combining clinic and MRI findings helps differentiate OGCTs from other OSGTs. These results help optimize clinical management and indicate that radiologists should focus on clinical information to help improve diagnostic accuracy.
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Affiliation(s)
- Jing Zhang
- Dept Imaging Ctr, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China; Dept Imaging Ctr, Northwest Women's and Children's Hospital, Xi'an, Shaanxi 710061, China
| | - Yi Zhang
- Dept Imaging Ctr, Northwest Women's and Children's Hospital, Xi'an, Shaanxi 710061, China
| | - Youmin Guo
- Dept Imaging Ctr, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
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Yamagishi T, Matsuyama M, Watanabe R, Sakai C, Matsumura S, Nakajima M, Kikuchi S, Sakamoto N, Sato Y, Hizawa N. A case of secondary pneumothorax due to multiple pulmonary metastases of granulosa cell tumor. Multidiscip Respir Med 2022; 17:884. [PMID: 36589027 PMCID: PMC9796701 DOI: 10.4081/mrm.2022.884] [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: 09/23/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Ovarian granulosa cell tumor is a relatively rare tumor that accounts for 2-5% of malignant ovarian tumors. This tumor progresses slowly and may recur late in life. Case presentation A 70-year-old woman was admitted to our hospital with a left secondary pneumothorax due to metastatic lung tumors of granulosa cell tumor. Reports of secondary pneumothorax due to granulosa cell tumor are rare. Thoracoscopic suturing and pleurodesis using talc were effective in the treatment of this pneumothorax. Conclusions We experienced a rare case of secondary pneumothorax due to multiple pulmonary metastases of granulosa cell tumor. It should be noted that pulmonary metastasis of granulosa cell tumor can lead to secondary pneumothorax.
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Affiliation(s)
| | - Masashi Matsuyama
- Department of Respiratory Medicine,Department of Respiratory Medicine, University of Tsukuba 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. +81.29.853-3144.
| | | | | | | | | | | | - Noriaki Sakamoto
- Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Zhuang Y, Zhang S, Liu Y, Yang H. Can adjuvant chemotherapy improve the prognosis of adult ovarian granulosa cell tumors?: A narrative review. Medicine (Baltimore) 2022; 101:e29062. [PMID: 35356927 PMCID: PMC10513366 DOI: 10.1097/md.0000000000029062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 02/24/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Adult granulosa cell tumors (aGCTs) are rare ovarian neoplasms with a relatively favorable prognosis. They follow an indolent course, characterized by a prolonged natural history and a tendency to late recurrences, Around a quarter of patients develop recurrence and More than 70% of women with recurrence die from their disease, The percentage of patients received chemotherapy increases over time, whether adjuvant chemotherapy improve the prognosis of aGCTs is equivocal? The purpose of this review is to summarize the previously published evidence to evaluate whether adjuvant chemotherapy improve the prognosis of aGCTs to provide guidance for clinical practice. EMBASE, PubMed, Web of Science, WanFang Data and Chinese National Knowledge Infrastructure are searched up to December 2020, used the search strategy of ovar* and granulosa cell* and (tumor* or tumour* or malignan* or cancer* or carcinom* or neoplasm*) and chemotherapy. The screening process was conducted strictly based on inclusion and exclusion criteria. Clinical studies based on human including randomized controlled trial, quasi-randomised controlled trials, nonrandomised trials cohort study and case control study were included without restriction of time. The percentage of patients received chemotherapy increases over time, but the benefit of adjuvant chemotherapy is lack of high-grade evidence of prospective study, based on the current retrospective studies, we still do not have the evidence to confirm the survival benefit of adjuvant chemotherapy in early stage, advanced stage or recurrent aGCT with no residual tumor, but for inoperable disseminated disease or disease with suboptimal cytoreduction, adjuvant chemotherapy maybe an Optable options. Multinational prospective randomised controlled trials are urgently needed to validate the role of adjuvant chemotherapy. Further research on molecular mechanisms and developing novel targeted medicines may improve the survival of aGCTs.
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Affiliation(s)
- Yuan Zhuang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,Sun Yat-sen University, Zhuhai, China
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15
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Edmund LN, Salama AM, Murali R. Cytologic features of sex cord-stromal tumors in women. Cancer Cytopathol 2022; 130:55-71. [PMID: 34411449 PMCID: PMC9439705 DOI: 10.1002/cncy.22502] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/14/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Gynecologic sex cord-stromal tumors (SCSTs) arise from sex cords of the embryonic gonad and may display malignant behavior. We describe the cytomorphologic features of SCSTs in females, including adult and juvenile granulosa cell tumors (AGCTs and JGCTs), Sertoli-Leydig cell tumors (SLCTs), and steroid cell tumors (SCTs). METHODS We retrieved available cytology slides from females with a histologic diagnosis of sex cord-stromal tumor between 2009 and 2020 from institutional archives and reviewed their cytoarchitectural features. RESULTS There were 25, 2, 2, and 1 cytology specimens from 19, 2, 2, and 1 patients (aged 7-90 years, median 57 years) with AGCT, JGCT, SLCT, and SCT, respectively. Features common to all SCSTs included 3-dimensional groups, rosettes, rare papillary fragments, abundant single cells and naked nuclei. Rosettes and a streaming appearance of cell groups were only seen in AGCTs, which also rarely featured eosinophilic hyaline globules and metachromatic stroma. AGCTs exhibited high nuclear:cytoplasmic (N:C) ratios, with mild nuclear pleomorphism, uniform nuclei with finely granular chromatin, nuclear grooves and small nucleoli; in contrast, other SCSTs lacked rosettes and nuclear grooves and had generally lower N:C ratios, greater nuclear pleomorphism, coarse chromatin and more abundant cytoplasm. Mitotic figures, necrosis, and inflammation were rarely identified. CONCLUSIONS AGCTs show cytomorphologic features that are distinct from those of other SCSTs. Careful evaluation of the cytological features and ancillary studies (eg, immunochemistry for FOXL2, inhibin and calretinin, or sequencing for FOXL2 mutations) can aid in the accurate diagnosis of these tumors.
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Affiliation(s)
- Liz N. Edmund
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, NY 10065, USA
| | - Abeer M. Salama
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, NY 10065, USA
| | - Rajmohan Murali
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, NY 10065, USA
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Prognostic predictors in recurrent adult granulosa cell tumors of the ovary: a systematic review and meta-analysis. Arch Gynecol Obstet 2021; 306:315-321. [PMID: 34799743 DOI: 10.1007/s00404-021-06305-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/18/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Ovarian adult granulosa cell tumours are low-grade malignant sex cord-stromal neoplasm with a low recurrence rate. Prognostic factors for recurrence include tumor stage, tumor rupture in Stage I neoplasms and the presence of residual tumors after surgery. However, in recurrent tumors, prognostic factors for overall survival (OS) are lacking. In the present paper, we conducted a systematic meta-analysis with the aim to assess prognostic factors for OS in patients with recurrent GCT. METHODS Electronic databases were searched for all studies assessing prognostic factors in recurrent adult granulosa cell tumor of the ovary. Student T test, Fisher's exact test and Kaplan-Meier survival analysis with long-rank test were used to assess differences among groups; a p value < 0.05 was considered significant. RESULTS Eleven studies analyzing 102 recurrent tumors were included in the systematic review. Tumor stage and localization of recurrent tumors were significantly associated with OS on Kaplan-Meier analysis; Cox regression analysis showed a HR of 0.879 for the stage II, of 3.052 for the stage III, and of 2.734 for stage IV tumor was significantly associated with OS (p = 0.037); observed HRs for abdominal and thoracic locations were of 2.405 and of 4.024, respectively. CONCLUSIONS In conclusion, the present article emphasizes the prognostic significance of tumor stage > II and extrapelvic anatomic sites of recurrences in patients with recurrent granuolase cell tumors of the ovary.
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Li J, Chu R, Chen Z, Meng J, Yao S, Song K, Kong B. Progress in the management of ovarian granulosa cell tumor: A review. Acta Obstet Gynecol Scand 2021; 100:1771-1778. [PMID: 34027996 DOI: 10.1111/aogs.14189] [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: 11/04/2020] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 11/29/2022]
Abstract
Ovarian granulosa cell tumor (GCT) is a rare, low-grade malignant tumor that accounts for 70% of the sex cord-stromal tumors. It has two histopathologic types with different clinical and biologic features: adult GCT and juvenile GCT. Most women diagnosed with the adult GCT have a favorable prognosis, with a 5-year survival rate of 97%-98%, but adult GCT has a feature of late relapse; the recurrence time could be more than 20 years after diagnosis. Juvenile GCT has a survival rate of 97% in stage I and a 5-year survival rate of 0%-22% in advanced stage with earlier recurrence than adult GCT. Consequently, the scenario emphasizes the need for early diagnosis, standardized treatment protocols, and long-term follow up. However, there is a lack of consensus regarding accurate diagnosis of GCT and adjuvant treatment. Furthermore, GCT tends to occur in young women, which emphasizes the viability of fertility-sparing surgery. The current review performed a systematic literature review of 60 articles to summarize the latest advances in GCT, with an emphasis on the molecular pathogenesis and survival after fertility-sparing surgery. We found that young women with fertility-sparing surgery had a desirable reproductive and survival outcome compared with those undergoing radical surgery.
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Affiliation(s)
- Junting Li
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ran Chu
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhongshao Chen
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jinyu Meng
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Shu Yao
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Kun Song
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Gynecology Oncology Key Laboratory, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Beihua Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Gynecology Oncology Key Laboratory, Qilu Hospital, Shandong University, Jinan, Shandong, China
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18
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Al Harbi R, McNeish IA, El-Bahrawy M. Ovarian sex cord-stromal tumors: an update on clinical features, molecular changes, and management. Int J Gynecol Cancer 2021; 31:161-168. [PMID: 33414107 DOI: 10.1136/ijgc-2020-002018] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/17/2022] Open
Abstract
Sex cord stromal-tumors are rare tumors of the ovary that include numerous tumor subtypes of variable histological features and biological behavior. Surgery is the main therapeutic modality for the management of these tumors, while chemotherapy and hormonal therapy may be used in some patients with progressive and recurrent tumors. Several studies investigated molecular changes in the different tumor types. Understanding molecular changes underlying the development and progression of sex cord-stromal tumors provides valuable information for diagnostic and prognostic biomarkers and potential therapeutic targets for these tumors. In this review, we provide an update on the clinical presentation, molecular changes, and management of sex cord-stromal tumors.
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Affiliation(s)
- Rehab Al Harbi
- Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, UK
| | - Iain A McNeish
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Mona El-Bahrawy
- Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, UK .,Department of Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
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