A case of late recurrence of a granulosa cell tumor of the ovary after laparoscopic surgery

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  • MIYAZAKI Nodoka
    Department of Obstetrics and Gynecology, Uji-Tokushukai Medical Center
  • TAKEDA Yoshinori
    Department of Obstetrics and Gynecology, Uji-Tokushukai Medical Center
  • KOKABU Tetsuya
    Department of Obstetrics and Gynecology, TOYOTA Memorial Hospital
  • SHINGAKI Kana
    Department of Obstetrics and Gynecology, Uji-Tokushukai Medical Center
  • KAWABE Koji
    Department of Obstetrics and Gynecology, Uji-Tokushukai Medical Center
  • TAKADA Shuichi
    Department of Obstetrics and Gynecology, Uji-Tokushukai Medical Center
  • KITAGAWA Satoshi
    Department of Pathology, TOYOTA Memorial Hospital
  • OGUCHI Hidenori
    Department of Obstetrics and Gynecology, TOYOTA Memorial Hospital

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Other Title
  • 腹腔鏡下手術後に晩期再発した卵巣顆粒膜細胞腫の1例
  • 症例報告 腹腔鏡下手術後に晩期再発した卵巣顆粒膜細胞腫の1例
  • ショウレイ ホウコク フククウキョウ シタテジュツゴ ニ バンキ サイハツ シタ ランソウ カリュウマク サイボウ シュ ノ 1レイ

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Attention must be paid to the possibility of the late recurrence of granulosa cell tumors of the ovary, and reports of recurrence after more than 10 years have been made. In all cases, this has occurred after laparotomy, and there have been no reports to date of late recurrence caused by laparoscopic surgery in Japan. We report here on our experience with a case of the recurrence of a granulosa cell tumor of the ovary 13 years after laparoscopic surgery. The patient was a 65-year-old female. When she was 52, a tumor in the right ovary was identified at this hospital and extirpated by laparoscopic surgery. The histological diagnosis was stage IC adult-type granulosa cell tumor of the right ovary. A non-mobile right adnexal mass the size of a goose’s egg was palpated at an internal examination during a follow-up examination 13 years after the initial surgery. Transvaginal ultrasonography showed an endometrial thickness of 8.6 mm and revealed a multilocular neoplastic lesion having a cystic lesion of 4.9×4.1 cm and a solid lesion of 2.7×2.6 cm in the right ovary. An 18FDG-PET revealed an abnormal accumulation of 18FDG only in mural nodule sites of the right ovarian tumor. The recurrence of a right ovarian granulosa cell tumor in the right ovary was diagnosed, and a laparotomy was performed. The right ovarian tumor had invaded the right bladder cavity, was fused to the right external iliac vein, and was embedded in the right pelvis. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed without intraoperative failure. No residual tumor was noted macroscopically. Pathological diagnosis was recurrence of adult-type granulosa cell and chemotherapy is currently being implemented. In addition to this case, recurrence, three years and five months after laparoscopic extirpation of granulosa cell ovarian tumors of the affected side has also been reported, thus, staging laparotomy should be considered after primary surgery. Additional treatment should be decided carefully considering the risk of recurrence and fertility preservation. [Adv Obstet Gynecol, 67(2) : 86-94, 2015 (H27.5)]

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