Current views on treatment of the ovarian granulosa-cell tumor

Abstract

Summary The granulosa-cell tumor ( folliculoma ) is a rare type of ovarian neoplasm, accounting for 5% of all cases [1]. It is the most common type of sex cord-stromal tumors, diagnosed in 70% of cases. The granulosa-cell tumor is a hormone active one, originating from granulosa cells which produce estradiol. Overproduction of estradiol is helpful in the diagnosis of the tumor because of its numerous symptoms. There are two types of folliculoma: juvenile (5%) and adult (95%). The juvenile type is mostly recognized ( 90% ) in FIGO I stage and has a better prognosis. Operation is often a sufficient way of treatment in this group [1]. Tumors in higher stages are more aggressive and must be treated further[ 2]. The adult folliculoma is more aggressive in its nature. Patients with the disease diagnosed in higher stages must be treated by adjuvant radiotherapy or chemotherapy[1]. Recurrence appears often many years after the treatment and has high mortality. Many old ( platinum) and new (taxans) agents are active when used in treatment of this type of tumor. Randomized study must be made to establish standard therapy of granulosa-cell tumor. Currently, the most frequent way of treatment is chemotherapy with BEP (Blemycyna, Etopozyd, Cisplatyna).