The patient was 36 years old with no family history and the following background: menarche: 13, G1P1A0, cesarean delivery to 26 years old, without toxic habits, required laparotomy which did not cause cancer.
At 30 years of age she consulted for hirsutism, overweight and amenorrhea.
She reported previous amenorrheal episodes controlled with OAC (oral contraceptives).
She had an ovarian cyst in follow-up.
In the pelvic ultrasound control, three months after the previous one, a great growth of this lesion was observed.
Right adnexectomy was performed, resulting in total hysterectomy, left adnexectomy, cystectomy and omentectomy when the intraoperative pathological result was known.
In the definitive specimen, a "Tumour of granulosa cells" of 6 cm was confirmed, fragmenting the capsule during surgery.
No other evidence of disease was staged as Ic.
Patient receiving chemotherapy adjuvant.
Protocolized follow-ups with gynecological examination, CT scan non-pelvic and chest X-ray were normal, until 6 years later an abdominal mass was observed on physical examination.
FNAC (needle aspiration biopsy) was positive for granulosa cell tumor.
A CT scan of the chest adjacent to the anterior pelvic region showed a marked bladder mass, cystoscopy cavity and tumor markers (BHCG, AFP, Ca 125, Ca 15.3, Ca 19.9 and CEA) in the left abdomen.
The mass and aponeurosis of the rectus muscles were excised.
The patient again received chemotherapy.
Two months later she suffered another recurrence in the abdominal wall.
The CT scan showed pelvic and anterior abdominal wall recurrence of 7 cm, with no other data of local or distant disease.
In November 2004, excision of the pelvic tumor and part of the rectus abdominis muscles, which ruptured, was performed.
GCT relapse was confirmed again.
The patient accepted the chemotherapy treatment and received a BEP scheme (bleomycin, methotrexate and cisplatin), which ended 6 months ago.
Currently there are protocolized reviews every 3 months, with no evidence of recurrence.
