Przybylski Marcin, Nowak Irmina, Gawron Dawid, Millert-Kalinska Sonja, Kippen Joanna, Pruski Dominik
District Public Hospital in Poznan, Poland.
District Public Hospital in Poznan, Poland; Doctoral School, Poznan University of Medical Sciences, Poland.
Int J Surg Case Rep. 2024 Dec;125:110549. doi: 10.1016/j.ijscr.2024.110549. Epub 2024 Oct 30.
Granulosa cell tumor (GCT) accounts for 3-5 % of all ovarian malignancies, being the most common among those originating from the sex cords and ovarian stroma. GCTs can be divided into juvenile and adult types, with the latter occurring mostly in perimenopausal women. These hormonally active tumors present diverse clinical manifestations, primarily related to elevated estrogen levels. The treatment is primarily surgical; other methods, mainly chemotherapy, are also used.
Three cases highlight the heterogeneity of GCTs. Case 1 involved a 34-year-old woman diagnosed with ovarian tumor during routine gynecological follow-up. Stage IA GCT was diagnosed. Fertility-sparing surgery followed by chemotherapy led to a favorable outcome, including two pregnancies. Case 2 involved a postmenopausal woman with a large pelvic mass. Surgery revealed a Stage IA GCT. Chemotherapy was stopped early due to complications. Case 3 featured a 47-year-old with acute abdominal symptoms caused by a ruptured GCT, leading to emergency surgery and subsequent radical treatment.
GCTs are hormonally active, causing symptoms such as abnormal bleeding or abdominal discomfort. Prognosis is generally favorable, especially in early-stage cases. Long-term surveillance is essential due to the potential for late recurrences. Fertility-sparing surgery is feasible in young patients, while chemotherapy is mainly used for advanced disease or recurrence.
GCTs, in addition to being rare, present with a wide range of clinical manifestations. Individualized treatment based on patient age, tumor stage, and fertility plans is crucial for favorable outcomes. Long-term monitoring is recommended due to the risk of late recurrence.
颗粒细胞瘤（GCT）占所有卵巢恶性肿瘤的3% - 5%，是源自性索和卵巢间质的肿瘤中最常见的类型。GCT可分为幼年型和成年型，后者多见于围绝经期女性。这些具有激素活性的肿瘤表现出多样的临床症状，主要与雌激素水平升高有关。治疗主要是手术；也会使用其他方法，主要是化疗。
三个病例突出了GCT的异质性。病例1涉及一名34岁女性，在常规妇科随访中被诊断出患有卵巢肿瘤。诊断为IA期GCT。保留生育功能的手术加化疗带来了良好的结果，包括两次怀孕。病例2涉及一名绝经后女性，盆腔有巨大肿块。手术显示为IA期GCT。因并发症化疗提前终止。病例3是一名47岁女性，因GCT破裂出现急性腹部症状，导致急诊手术及后续根治性治疗。
GCT具有激素活性，可引起异常出血或腹部不适等症状。预后总体良好，尤其是早期病例。由于存在晚期复发的可能性，长期监测至关重要。保留生育功能的手术对年轻患者可行，而化疗主要用于晚期疾病或复发情况。
GCT除了罕见外，临床表现多样。根据患者年龄、肿瘤分期和生育计划进行个体化治疗对于取得良好结果至关重要。由于存在晚期复发风险，建议进行长期监测。
