Granulosa cell tumor - Different faces of one neoplasm. A case series

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.