Atypical presentation as large ruptured tumor with associated mesosigmoid hematoma of an ovarian granulosa cell tumor recurrence

Granulosa cell tumors of the ovary represent a rare subtype of ovarian malignancies which is usually associated with low recurrence rates due to the fact that is usually diagnosed in early stages of the disease. The aim of the current paper is to report the case of a 50 year old patient diagnosed with such a recurrence at four years after the initial diagnostic. Case report: the 50 year old patient was initially submitted to surgery for an ovarian tumor at that moment radical surgery being performed. Four years later she self referred to our service for diffuse abdominal pain and was diagnosed with a presumptive hematoma at the level of the mesosigmoid loop in association with increased values of serum inhibin. The patient was submitted to surgery, intraoperatively a ruptured tumor in association with mesosigmoidian hematoma being discovered; therefore the lesion was resected en bloc with the rectosigmoidian loop. The histopathological studies confirmed the presence of negative resection margins. In conclusion, although granulosa cell tumors of the ovary rarely develop distant metastases, isolated recurrences might occur and in such cases radical resection seem to be an effective therapeutic option.