A case of adult granulosa cell tumor of the ovary with long-term survival after multiple recurrences

• DOI: 10.1016/j.tjog.2022.06.006
• Publication Date: 2022-09-07T10:44:29Z
• Authors: Angel Hsin-Yu Pai; Ren-Chin Wu; Feng-Yuan Liu; Chiao-Yun Lin; Yenpo Lin; Chyong-Huey Lai
• Keywords: Positron emission tomography; 03 medical and health sciences; 0302 clinical medicine; Complete cytoreductive surgery; Recurrence; RG1-991; Gynecology and obstetrics; Megestrol acetate; Adult granulosa cell tumor

Objective: To illustrate the clinical course of a rare case of recurrent adult granulosa cell tumor (AGCT) and discuss the features and management for recurrences. Case report: A 56-year-old female was first diagnosed with AGCT in 2008 and had uneventful, regular follow-ups until 2013. Recurrence was suspected and proven by computed tomography-guided biopsy. After undergoing complete cytoreductive surgery (CRS) followed by adjuvant megestrol acetate then leuprolide acetate, another recurrence sprouted at the presacral area in 2017. On both occasions, CRS with no visible residual tumor were attained. The patient has remained in complete remission to date with progestin therapy. Conclusion: There are currently no standardized tumor markers, imaging exams, or therapies for managing AGCT recurrences. Whole exome sequencing analysis of our patient suggested possible association with triosephosphate isomerase 1 mutation. Regular follow-ups with at least two types of imaging exams and indefinite hormone therapy are crucial for this patient's remission.