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  • Granulosa Cell Tumor

    A Granulosa Cell Tumor (GCT) is one of the rarest forms of ovarian cancer and is classified as a sex cord stromal tumor.

    Although more common in post-menstrual women, it has the ability of growing in both male and female children (referred to as a juvenile tumor), as well as in men of any age. Often mistaken as a simple ovarian cyst, GCT is usually benign but has a good recovery reputation.

    If the tumor is discovered while in stage I, survival is extremely likely. Its appearance is solid, smooth-surfaced, and cystic lesion with blood-filled cysts. The cells have the ability of spreading to other organs of the body and where new tumors are grown in organs such as the lungs. Very little research has been conducted as to why this occurs, but it might have something to do with the cells being malignant.

    Granulosa cell tumors can occur once treated up to two decades later. Sometimes it is associated with endetrial hyperplasia, which is an excessive cell growth in the lining of the uterus. Strangely enough, Granulosa cells produce excessive amounts of estrogen, predominantly in females if the tumor is active due to abnormal production of steroid hormones.

    Such amounts can contribute to an increase in hair growth, a deepening of the voice, balding, excessive muscle mass, and enlargement of the clitoris. Although the cause of GCT is not known, possibilities of it being derived from Mesenchyme and Mesonephric are likely.

    Statistics and Prognosis

    Granulosa cell tumors occur at the peak age of 50-55, but can occur earlier in life. They are known to reappear as much as a decade or two after one is diagnosed. Being a very slow and lazy tumor, it accounts for 25,000 new cases of ovarian cancer in the U.S. annually, and generally, 2% of all ovarian tumors.

    • 70% of GCT are hormonally active.
    • A current 90-95% survival rate for stage I tumors.
    • A current 20-25% survival rate for advance staged tumors.
    • 10% of GCTs occur in pregnant women.
    • 95% occur in adults which 5% occurs in children. (Known as Juvenile tumors)

    PROGNOSIS FOR MEN

    GCT can occur in men, but the likelihood is smaller than that of women. It is the least common sex cord stromal tumor found in the testes.

    • Account for 27% of Gonadal tumors. (Non-germ cell origin)
    • Appear as cystic, painless testicular masses.
    • Associated with defects (anomalies) of the Y chromosome.

    PROGNOSIS FOR CHILDREN (JUVENILE TUMORS):

    Unlike GCT in women and men, juvenile tumors do not produce estrogen. They are very rare, but occur in both males and females.

    Boys

    • Associated with defects (anomalies) of the Y chromosome.
    • Hormonally inactive & benign.
    • Occur as early as first 6 months of life up to 1 yr.
    • Reoccur in the first 3 years of diagnosis.

    Girls

    Hormonally inactive & benign, although they may cause menstrual cycle to begin early.

    Risk Factors

    • Age (post-menstrual women/ 50-55 years old)
    • Number of children (more children reduces chances)
    • High fat diets
    • Ovarian cancer in family history
    • Infertility drug use

    Symptoms

    • Nausea, vomiting, dizziness, shoulder pain
    • Post menopausal- abnormal vaginal bleeding
    • No longer ovulating
    • Abdominal/Pelvic pain
    • Bloating
    • Frequent urination
    • Fatigue/backaches/migraine headaches
    • Enlarged breasts
    • Pain during intercourse

    Treatment

    Many women are treated with a full hysterectomy, but chemotherapy is also an option. Some women prefer surgery to have as much as the tumor removed as possible. It is very important to visit your doctor regularly in case signs of reappearance are present. Other treatments include:

    • Appendectomy (excision of the vermifor appendix)
    • Salpingo-oophorectomy (surgical removal of an ovary and its fallopian tube)
    • Pelvic node dissection (removal of cancer carrying lymph nodes)
    • Partial omentectomy

    Prevention

    There aren’t many ways to prevent GCT, although it is possible to detect it early. (Most are found in stage I)

    • Ultra sound
    • Frequent thorough check-ups
    • Pelvic exams