Thursday, March 28, 2024
HomeObstetrics & GynecologyGranulosa-Theca Cell Tumors

Granulosa-Theca Cell Tumors

Practice Essentials

Granulosa-theca cell tumors, also known as granulosa cell tumors (GCTs), represent about 2% of all ovarian tumors. GCTs can be divided into adult (95%) and juvenile (5%) types based on histologic findings. See the image below.

Microfollicular pattern of an adult granulosa cell

Microfollicular pattern of an adult granulosa cell tumor at 100X magnification. Inset is characteristic Call-Exner bodies and nuclear grooves (400X). Image courtesy of James B. Farnum, MD, TriHealth Department of Pathology.

View Media Gallery

Signs and symptoms

Many patients with GCTs exhibit manifestations of hyperestrogenism. These symptoms vary depending on the patient’s age and menstrual status. In most patients, a palpable mass can be detected during the physical examination.

See Presentation for more detail.

Diagnosis

Laboratory studies

A pregnancy test is recommended for all reproductive-aged patients (even at the extremes of reproductive age) who present with abdominopelvic symptoms.

The standard laboratory workup for a patient with an adnexal mass varies depending on patient age, as follows:

In patients who are prepubertal or younger than 30 years, especially if the mass has solid components: Beta–human chorionic gonadotropin (bhCG), alpha-fetoprotein (AFP), lactate dehydrogenase (LDH), and cancer antigen 125 (CA125)

In reproductive-aged women older than 30 years: CA125 test, serum inhibin levels, and serum sex hormone levels if clinical findings are consistent with excess hormone production

In postmenopausal women: CA125 test and serum sex hormone levels if findings are consistent with excess hormone production

Ancillary laboratory studies that may be useful include stool guaiac testing, complete blood cell (CBC) count with differential, blood chemistries, urinalysis, and cervical cultures for gonorrhea and chlamydia.

Imaging studies

Imaging studies that may be useful in the workup include the following:

Transvaginal sonography

Chest radiography

Abdominopelvic computed tomography (CT) scanning or magnetic resonance imaging (MRI)

Mammography: For women aged older than 40 years who have not had a mammogram in the preceding 6-12 months

See Workup for more detail.

Management

Surgery is considered first-line therapy for patients with GCTs. Chemotherapy can be used as adjuvant therapy in patients with advanced or recurrent disease and has been effective in improving disease-free survival. A number of different chemotherapy regimens have been used in this setting, with varying toxicity and response rates.

See Treatment and Medication for more detail.

Previous articleVaricose Vein Surgery
Next articleCervical Screening
RELATED ARTICLES
- Advertisment -

Most Popular