Faten LIMAIEM*, Saloua MEJRI, Imen KHELIL, Ahlem LAHMAR, Saadia BOURAOUI, Sabeh MZABI-REGAYA
Department of Pathology. Mongi Slim Hospital, La Marsa, University of Tunis El Manar, Tunis Faculty of Medicine, 1007, Tunisia
Received: 10 December, 2015; Accepted: 23 December, 2015;Published: 24 December, 2015
Faten Limaiem, Department of Pathology. Mongi Slim Hospital, La Marsa, University of Tunis El Manar, Tunis Faculty of Medicine, 1007. +216 96 55 20 57; E-mail:
LIMAIEM F, MEJRI S, KHELIL I, LAHMAR A, BOURAOUI S, et al. (2015) Adult Granulosa Cell Tumours of the Ovary Seven Case Reports. J Gynecol Res Obstet 1(1): 013-016.
© 2015 LIMAIEM F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Ovary; Adult granulosa cell tumour; Histopathology
Background: Ovarian granulosa cell tumours are low-grade malignant sex cord-stromal tumours. They represent 2 to 3% of all ovarian cancers and occur mainly within the adult population.
Aim: to provide an updated overview on ovarian adult granulosa cell tumours.
Patients and Methods: in our retrospective study, we reviewed seven cases of adult granulosa cell tumours that were diagnosed at the pathology department of Mongi Slim hospital over a fourteen-year period (2002- 2015). Clinical and pathRIiological characteristics were retrospectively analyzed.
Results: The patients of our series ranged in age between 39 and 64 years (mean = 53 years). The most common presenting symptom was abnormal uterine bleeding (n=5) followed by pelvic pain (n=4). All patients underwent surgical treatment including total hysterectomy with bilateral salpingo-oophorectomy (n=4), hysterectomy with right salpingo-oophorectomy (n=1) and salpingo-oophorectomy (n=2). Histopathological examination of the surgical specimen confirmed the diagnosis of adult granulosa cell tumour in all cases.
Conclusions: Adult granulosa cell tumours of the ovary are considered as low grade malignancies with a relatively more favourable prognosis compared with much more commonly encountered epithelial ovarian tumours. A prolonged post-therapeutic follow-up is necessary because of the risk of recurrences.
Ovarian granulosa cell tumours (GCTs) are uncommon neoplasms that arise from the sex-cord stromal cells of the ovary and represent 2% to 3% of all ovarian cancers [1,2]. There are two histological forms: an adult form (95%) and a juvenile form (5%). Ovarian granulosa cell tumours are characterized by tendency to late recurrences and a favorable overall prognosis. In this paper, we report seven cases of adult GCTs of the ovary that were diagnosed at our institution over the past fourteen-year period. The aim of this study was to analyze epidemiological characteristics, clinical symptoms, radiological features, treatment and outcomes of seven patients who were surgically treated at our institution.
Patients and Methods
We undertook a retrospective study of seven patients who were operated on for ovarian adult GCTs at the Gynecology department of Mongi Slim hospital of Tunis between March 2002 and August 2015. The cases were retrieved from the files of the registry of surgery of the same hospital. Medical records were scrutinized for epidemiologic characteristics, predisposing factors, initial manifestations of the disease, methods of diagnosis, laboratory findings and surgical treatment. Diagnosis of the adult GCTs was based upon clinical, imaging and histopathological findings. All patients underwent imaging evaluation during the preoperative period. All specimens were surgically obtained. Tissues were fixed in 10% phosphate buffered formaldehyde, embedded in paraffin and sections were prepared for routine light microscopy after staining with hematoxylin and eosin. Patient confidentiality was maintained.
Our study group included seven female patients between 39 and 64 years of age (mean = 53 years). Two patients presented with co-morbidities namely hypertension (n=1) and diabetes (n=1). The presenting clinical symptoms were dominated by abnormal uterine bleeding (n=5) followed by pelvic pain (n=4) (Table 1).
Radiological findings and localization
Diagnostic imaging techniques included ultrasonography in all cases and CT scan in two cases. In our series, five tumours were heterogeneously solid and two were multiseptated cystic masses. Hemorrhage was present in two cases.
All patients underwent surgical treatment including total hysterectomy with bilateral salpingo-oophorectomy (n=4), hysterectomy with right salpingo-oophorectomy (n=1), and salpingo-oophorectomy (n=2).
Macroscopic findings (Figures 1,2): In our series, ovarian adult GCTs varied in size from 6,5 to 23 cm (mean = 15,14 cm). On cut section, the tumours were solid and cystic. The solid areas were soft and tan to yellow. Necrosis was noted in four cases and hemorrhage in two cases. Histopathological examination of the surgical specimen (Figures 3,4) confirmed the diagnosis of adult GCTs in all cases. In one case, endometrial hyperplasia was noted. Histopathological findings of ovarian adult GCTs of our series are summarized in Table 2.