The ovaries contain several cell types supporting the eggs. One of these cell types is the granulosa cell, which helps to produce estrogen, other steroids and growth factors for the eggs. Overgrowth of granulosa cells is a granulosa cell tumor. Although normal granulosa cells are found in the ovaries, granulosa cell tumors can arise in the ovaries or testes.
Types
There are two types of granulosa cell tumors: adult and juvenile. The DoctorsDoctor.com website notes that the adult type is the more common of the two. The adult type tends to be found in adults more often, and the juvenile in youth, but this is not always the case, as either type can be found in adults or children. Approximately 95 percent of granulosa cell tumors are the adult type.
Frequency
According to TheDoctorsDoctor.com, adult granulosa cell tumors comprise about two to five percent of all ovarian tumors. A 2008 article in Integrative Cancer Therapy notes that a diagnosis of juvenile granulosa cell tumors peaks at ages 8 to 9, and ages 13 to 18. The average age of adult granulosa cell tumors is 50 to 54. About 1 in 100,000 persons per year develops these tumors. In addition, these ovarian tumors are associated with tumors in the uterus.
Symptoms
According to the study in Integrative Cancer Therapy, these tumors tend to make hormones such as estrogen, and in children who have not undergone puberty, the development of a granulosa cell tumor can start an early puberty. In women of reproductive age, the most common symptoms are abdominal pain and irregular menstrual periods. In women who are past menopause, common symptoms are abdominal pain and uterine bleeding. Occasionally a tumor may rupture, causing pain and bleeding into the abdomen.
Diagnosis
A history of abnormal bleeding and abdominal pain generally prompts an abdominal exam, which may reveal a mass that can be felt. Imaging by CT scan can confirm the presence of a mass. Lab studies on the blood can also find evidence of the tumor, for example, estrogen levels may be higher than normal. Definitive diagnosis is made by removing the tumor and examining it under a microscope.
Treatment
Treatment of granulosa cell tumors depends on how extensive the tumor is. If not extensive, it may suffice to take out the affected ovary and uterine tube. More advanced disease may call for removal of both ovaries as well as the uterus. Advanced disease or a recurrence is treated with chemotherapy as well. Radiation may also be indicated.
Prognosis
In patients with lesser involved disease, the 10-year survival rates are about 90 percent, in other words, the patients were followed for 10 years to come up with the rate of survival, and 9 out of 10 survived. In more advanced disease, the survival rates are about 57 percent. In the two most advanced stages, the 10-year survival rates is about 25 percent.
