Retrospective Study of the Clinicopathological Characteristics of Adult Granulosa Cell Tumour of the Ovary at a Tertiary Care Centre

Aim This retrospective analysis aimed to evaluate the clinicopathological characteristics of adult granulosa cell tumours (AGCT) treated at a tertiary care centre. Materials and Methods Demographic, clinicopathological, treatment and follow-up details of all patients with AGCT treated from January, 2003 till July, 2014 were extracted from institutional cancer registry and Electronic Medical Records, after obtaining necessary clearance from institutional ethical committee, and institutional review board. The details obtained were tabulated and analyzed. Results Thirty-three patients were identified to have AGCT; 24 at initial diagnosis and nine at recurrence. Mean age at diagnosis among patients seen at initial diagnosis and those at recurrence was 50.42 years versus 40.78 years, while mean tumour size was 11.9 cm and 14.8 cm respectively. Abdominal pain was most common symptom at presentation. All patients had upfront surgery. Of the 24 cases seen initially, 16 had staging surgery; among whom six were second surgery, one in the fertility sparing group, and five in the non-sparing group. None were upstaged. Complete resection was feasible in all 16. Three cases had fertility preserving surgery. Among the patients who had staging surgery, 81.25% were stage I and the rest stage IIb. Six patients received postoperative chemotherapy. The mean follow-up period was 42.08 months. Mean time to relapse among the nine recurrent cases was 92.79 months. All patients had intra-abdominal recurrence, pelvis and omentum being the most common sites. Resection of metastatic sites was done in all nine cases. Three patients received preoperative chemotherapy and one received postoperative radiotherapy. The mean overall survival was 170.18 months. Conclusions Complete resection of tumour is feasible both in primary and recurrent cases. Fertility preserving surgery may be offered to women with early-stage disease who opt to retain fertility. Long term follow-up with pelvic and whole abdominal surveillance is necessary.