In vitro fertilization with granulosa cell tumor: a report of two cases

Excerpt

Granulosa cell tumors (GCT), a subset of sex cord-stromal tumors, encompass 1–2% of all ovarian tumors and 2–5% of all ovarian malignancies [1]. The adult subtype is predominant, and molecular testing reveals a mutation in the FOXL2 gene in 97% of tumors examined [2]. There is increased incidence of granulosa cell tumors in non-white, obese women with family history of breast or ovarian cancer. Adult GCT is the most common ovarian tumor to produce endocrinopathy, and patients may present with an abdominal mass and symptoms of hyperestrogenism, irregular menses, abnormal uterine bleeding, post-menopausal bleeding, breast tenderness, and sexual precocity in children. Treatment involves complete resection and surgical staging followed by either observation for low-risk stage 1 cancer or platinum-based chemotherapy for higher stage cancer [3]. Initial fertility sparing surgery can be an option for patients but should be followed by total hysterectomy and bilateral salpingo-oophorectomy once childbearing is complete as recurrence can occur many years later [4]. …