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Ginecología y obstetricia de México
versão impressa ISSN 0300-9041
Resumo
LOPEZ-GONZALEZ, Elga; SILLERO-CASTILLO, Ana e ESCRIBANO-COBALEA, María. Adult granulosa cell tumor. Ginecol. obstet. Méx. [online]. 2021, vol.89, n.12, pp.1002-1008. Epub 23-Maio-2022. ISSN 0300-9041. https://doi.org/10.24245/gom.v89i12.5510.
BACKGROUND:
Granulosa cell tumor represents 2 to 5% of ovarian neoplasms. Its clinical manifestation is not always specific.
OBJECTIVE:
To analyze the behavior of granulosa cell tumor and to provide experience for its treatment.
CLINICAL CASE:
A 52-year-old patient with granulosa cell proliferation with scant cytoplasm and ovoid nuclei, some of them with prominent grooves, with trabecular and diffuse growth pattern. The initial manifestation was an episode of postmenopausal bleeding that raised suspicion of endometrial pathology. Immunohistochemistry was positive for inhibin and weakly positive for alpha-fetoprotein, negative for broad-spectrum cytokeratins, EMA and chromogranin; ki-67: 5-10%. Hysterectomy and double adnexectomy by laparoscopy and omentectomy were indicated. With the diagnosis of granulosa cell tumor stage IC, adjuvant treatment with chemotherapy was indicated, 3 cycles of bleomycin, etoposide and cisplatin. Follow-up was carried out with ultrasound and inhibin B concentrations, which have remained within normal limits in the periodic control.
CONCLUSION:
Granulosa cell tumor is of low malignancy grade and preferably local dissemination. Its prognosis is excellent, although due to its recurrence, years after the initial diagnosis it seems reasonable to prolong surveillance with physical examinations and the study of tumor markers.
Palavras-chave : Granulosa cell tumor; Ovarian neoplasms; Proliferation; Cytoplasm; Postmenopausal; Immunochistochemistry; Alpha fetoprotein; Hysterectomy.