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• W1610352671 abstract "O granulosa cell tumors (GCT) are rare neoplasms that arise from the sex cord stromal cells of the ovary and represent 2% to 5% of all ovarian cancers.1 The tumors most commonly affect adults, but 5% present in prepuberty.1 Peak incidence of GCT is in the age group of 50-55 years.1 Granulosa cell tumors are hormonally active tumors and the main symptoms are a result of hyperestrogenism. In the reproductive age group, patients may have menstrual irregularities such as menorrhagia, intermenstrual bleeding, or amenorrhea, and in postmenopausal women, abnormal uterine bleeding may be the presenting symptom.1 However, acute pelvic pain caused by tumor rupture and hemoperitoneum may be rarely the first sign of disease. We present a rare cause of acute abdomen syndrome due to ruptured ovarian GCT in a premenopausal woman. A 45-year-old multiparous premenopausal patient was admitted to our emergency service with acute pelvic pain. Vital signs were stable except for tachycardia. Abdominal tenderness and left adnexal mass was detected by pelvic examination. The patient complained of menometrorrhagia for 3 months and all laboratory tests including complete blood count, s-human chronic gonadotropin, and infection markers were within normal limits. A solid mass (82x67 mm) in the left ovary with 73x22 mm free intra-abdominal liquid was determined during the transvaginal ultrasonographic examination (Figure 1). Doppler measurement of the mass was resistance index (RI): 0.57 and pulsatility index (PI): 0.86 (Figure 2). Hemoglobin level showed a decreasing pattern, and acute abdomen symptoms developed during the follow-up period. Therefore, laparoscopic surgery was performed. At surgery, ruptured left ovarian mass, and intra-abdominal 1000 cc of fresh and old blood clots were detected. Laparoscopic left salpingo-oophorectomy was performed. Frozen section examination was reported as GCT. Therefore, the operation was extended to the right salpingooferectomy, total abdominal hysterectomy, bilateral pelvic, and para-aortic lymphadenectomy. Final pathologic examination was reported as “stage IC granulosa cell tumor.” The patient received platinum-based adjuvant chemotherapy, postoperatively. Granulosa cell tumors are rare and reported incidents of 0.58-1.6/100.000 women a year.2 These tumors secrete estradiol, and this is responsible for the clinical signs like menorrhagia, intermenstrual bleeding or amenorrhea.3 Approximately 25-50% of GTCs are associated with endometrial hyperplasia whereas 5-13% are associated with an endometrial cancer.1 Endometrial cancer related to GTCs is usually well differentiated, at early stage and with good prognosis. Granulosa cell tumors are staged surgically according to the International Federation of Gynecology and Obstetrics ovarian cancer staging system. Assessment of stage is the most important factor in determining prognosis and to guide postoperative treatment recommendations. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and lymphadenectomy is recommended for women who are done with Clinical Note" @default.
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• W1610352671 date "2012-08-01" @default.
• W1610352671 modified "2023-09-23" @default.
• W1610352671 title "Ruptured ovarian granulosa cell tumor as a cause of hemoperitoneum." @default.
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