Adult Granulosa Cell Tumor Associated With Peritoneal Endometriosis: Is It Fair To Preserve Fertility?

Introduction/Background The adult granulosa cell tumor (GCT) is derived from ovarian sex-cord stromal cells in the ovaries. It is a rare type of cancer, which accounts for 2–5% of all cases of ovarian carcinoma and have a better prognosis of ovarian epithelial types. The standard treatment is cytoreductive surgery, but in selected cases it is possible to perform conservative surgery with complete staging for patients with a desire to preserve fertility. However, we found a small number of cases described in the literature. Endometriosis is a common condition present in reproductive-aged women. Some studies have shown endometriosis associated to some types of ovarian cancer, specially endometrioid and clear cells, however, none related to GCT. Methodology Case report. Results A 37-year-old nulliparous woman presented with abdominal pain and a left ovarian mass. Computed Tomography (CT) confirmed a 5 cm left ovarian mass and underwent a laparoscopic cystectomy. Adult GCT was confirmed stage IA disease. Staging laparotomy including pelvic washed, pelvic lymphadenectomy, infra-colic omentectomy and multiple stripping of the pelvic peritoneum. During procedure peritoneal endometriosis have been identified. Conclusion GCTaffects young patients and fertility preservation is thus an important issue. However, the role of fertility-sparing surgery remains unclear. Recurrences occur 5 years after the first treatment. However, the finding of endometriosis, although peritoneal, should be evaluated with criteria for reducing the chance of spontaneous gestation. It has been advised against use of gonadotrophins to ovarian stimulation and egg collection because of the risk of GCT dissemination. The patient was informed that there is limited evidence in the safety of this approach. Regular follow-up, was proposed including physical examination, tumor markers and CT scan. Disclosure Nothing to disclose.