Rapidly Growing Ovarian Granulosa Cell Tumor Following Complete Debulking for Suspected Ovarian Cancer with Histopathology Result of Benign Ovarian Cyst

Syamel Muhammad, Puja Agung Antonius, Rizki Oktavian, Aisha Savannah


Ovarian granulosa cell tumor (GCT) is a rare low-grade malignancy condition. One type of GCT is adult GCT (AGCT), which has the tendency for late recurrence. AGCT is clinically palpable and focally cystic and solid. In this case report, a condition of recurrent ovarian cancer after laparotomy debulking surgery was reported. A 57-year-old woman, who was diagnosed with AGCT, had a history of laparotomy debulking three months prior and complained of abdominal pain and enlargement, along with significant weight loss. Ultrasound examination revealed a solid cyst, raising suspicion of recurrent ovarian cancer. Laboratory results indicated elevated CA-125 levels. Histopathology results confirmed metastasis of AGCT, after the second laparotomy debulking was done. Recurrence of GCT is uncommon within three months of debulking. In this rare condition, we suggested a laparotomy debulking and adjuvant chemotherapy as a treatment. Effectiveness of treatment of recurrent disease is an independent risk factor to reduce the risk of another relapse and increase the survival rate.

Keywords: granulosa cell tumor, ovarian cancer, debulking

Full Text:



Saragih CF, Rivany R, Sahil MF, Fadjrir, Ardiansyah E, Yaznil MR, et al. The difference of Bax protein expression between endometrioma and ovarian carcinoma. Mol Cell Biomed Sci. 2019; 3(2): 95-9, CrossRef.

Seagle BLL, Ann P, Butler S, Shahabi S. Ovarian granulosa cell tumor: A National Cancer Database study. Gynecol Oncol. 2017; 146(2): 285-91, CrossRef.

Shim SH, Sun JL, Kim DY, Jin K, Kim SN, Kang SB, et al. A long-term follow-up study of 91 cases with ovarian granulosa cell tumors. Anticancer Res. 2014; 34(2): 1001-10, article.

Khosla D, Dimri K, Pandey AK, Mahajan R, Trehan R. Ovarian Granulosa cell tumor: Clinical features, treatment, outcome, and prognostic factors. N Am J Med Sci. 2014; 6(3): 133-8, CrossRef.

Li X, Tian B, Liu M, Miao C, Wang D. Adult-type granulosa cell tumor of the ovary. Am J Cancer Res. 2022; 12(8): 3495-511, article.

Thomakos N, Biliatis I, Koutroumpa I, Sotiropoulou M, Bamias A, Liontos M, et al. Prognostic factors for recurrence in early stage adult granulosa cell tumor of the ovary. Arch Gynecol Obstet. 2016; 294(5): 1031-6, CrossRef.

Ottolina J, Ferrandina G, Gadducci A, Scollo P, Lorusso D, Giorda G, et al. Is the endometrial evaluation routinely required in patients with adult granulosa cell tumors of the ovary? Gynecol Oncol. 2015; 136(2): 230-4, CrossRef.

Sehouli J, Drescher FS, Mustea A, Elling D, Friedmann W, Kühn W, et al. Granulosa cell tumor of the ovary: 10 years follow-up data of 65 patients. Anticancer Res. 2004; 24(2C): 1223-9, article.

Mangili G, Ottolina J, Gadducci A, Giorda G, Breda E, Savarese A, et al. Long-term follow-up is crucial after treatment for granulosa cell tumours of the ovary. Br J Cancer. 2013; 109(1): 29-34, CrossRef.

Sekkate S, Kairouani M, Serji B, Tazi A, Mrabti H, Boutayeb S, et al. Ovarian granulosa cell tumors: A retrospective study of 27 cases and a review of the literature. World J Surg Oncol. 2013; 11: 142, CrossRef.

Vani BR, Geethamala K, Geetha RL, Srinivasa MV. Granulosa cell tumor of ovary: A clinicopathological study of four cases with brief review of literature. J Midlife Health. 2014; 5(3): 135-8, CrossRef.

Gu Y, Wang D, Jia C, Chen L, Cang W, Wan X, et al. 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(6): 782-90, CrossRef.

Charkhchi P, Cybulski C, Gronwald J, Wong FO, Narod SA, Akbari MR. CA125 and ovarian cancer: A comprehensive review. Cancers. 2020; 12(12): 3730, CrossRef.

Babarović E, Franin I, Klarić M, Ferrari AM, Karnjuš-Begonja R, Eminović S, et al. Adult granulosa cell tumors of the ovary: A retrospective study of 36 FIGO stage I cases with emphasis on prognostic pathohistological features. Anal Cell Pathol. 2018; 2018: 9148124, CrossRef.

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(2): 321-4, CrossRef.

Zhao D, Zhang Y, Ou Z, Zhang R, Zheng S, Li B. Characteristics and treatment results of recurrence in adult-type granulosa cell tumor of ovary. J Ovarian Res. 2020; 13(1): 19, CrossRef.

Wang D, Xiang Y, Wu M, Shen K, Yang J, Huang H, et al. Clinicopathological characteristics and prognosis of adult ovarian granulosa cell tumor: A single-institution experience in China. Onco Targets Ther. 2018; 11: 1315-22, CrossRef.

Ray-Coquard I, Morice P, Lorusso D, Prat J, Oaknin A, Pautier P, et al. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018; 29(Suppl 4): iv1-18, CrossRef.

Koukourakis GV, Kouloulias VE, Koukourakis MJ, Zacharias GA, Papadimitriou C, Mystakidou K, et al. Granulosa cell tumor of the ovary: Tumor review. Integr Cancer Ther. 2008; 7(3): 204-15, CrossRef.

DOI: https://doi.org/10.21705/mcbs.v7i3.352

Copyright (c) 2023 Cell and BioPharmaceutical Institute

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Indexed by:



Cell and BioPharmaceutical Institute