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Aggressive adult granulosa cell tumor of the ovary without a FOXL2 mutation: A case report
Author(s) -
Watanabe Koichi,
Abiko Kaoru,
Minamiguchi Sachiko,
Maeda Hirona,
Murakami Ryusuke,
Kitamura Sachiko,
Horie Akihito,
Mandai Masaki
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13969
Subject(s) - medicine , ovary , laparotomy , pathology , granulosa cell , carboplatin , immunohistochemistry , proliferation index , high power field , chemotherapy , surgery , cisplatin
We report a case of aggressive adult granulosa cell tumor (AGCT) of the ovary. On presentation, the tumor was localized in the right ovary; a total abdominal hysterectomy, bilateral salpingo‐oophorectomy and partial omentectomy were performed. While some areas of the tumor represented typical AGCT, other areas showed enlarged and hyperchromatic nuclei with numerous mitoses (>10/high‐power field) with marked necrosis. The results of immunohistochemical analysis were compatible with AGCT, except that, in the necrotic portion, p53 was strongly positive, and the Ki‐67 index was high. Four months after laparotomy, recurrent tumors developed in the bones, liver, lungs and dura mater. The patient responded well to chemotherapy consisting of five cycles of paclitaxel and carboplatin, but later, the tumors rapidly proliferated, and the patient died of disease 11 months after laparotomy. FOXL2 examination demonstrated that both portions of the primary tumor did not have a point mutation (402C→G) specific to AGCT.