Does Ovarian Tumor Size Predict Endometrial Cancer in Patient with Ovarian Adult Granulosa Cell Tumors?

Abstract Objective: The main feature of adult granulosa cell tumors (AGCT) is their capacity to secrete hormones, with nearly all of them capable of synthesizing estradiol. Endometrial pathology is caused by granulosa cell-produced estrogen exposure. The primary goal of this study is to identify endometrial pathologies, particularly the endometrial cancer, in AGCT patients who had undergone hysterectomy. The secondary objective of the study is to define the factors that predict endometrial cancer in AGCT. Materials and Methods : The study cohort was formed with 316 AGCT patients from ten tertiary gynecological oncology centers. Surgery for AGCT consisted of bilateral salpingo-oophorectomy, hysterectomy, peritoneal cytology, omentectomy, excision of any suspicious lesion. Endometrial hyperplasia was categorized as simple hyperplasia without atypia, complex hyperplasia without atypia, complex hyperplasia with atypia or endometrial intraepithelial neoplasia (EIN). The median tumor size value was used to define the relationship between tumor size and endometrial cancer. The relationship of each value with endometrial cancer was evaluated. Results: EIN or hyperplasia with complex atypia was detected in 7.7% of patients and endometrial cancer in 3.2% of patients. The relationship between tumor size and endometrial cancer was evaluated by taking the tumor size as a cut-off value of 150 mm. Therefore, tumor size ≤150 mm four (3.2%) and >150 mm four (12.1%) patients had endometrial cancer ( p =0.036). Tumor size was statistically significant in relation to endometrial cancer in menopausal AGCT patients. Conclusion: Our present study determined that 7.3% of patients had complex hyperplasia with atypia or EIN and 3.1% of patients had endometrial carcinoma. During the menopausal period, endometrial cancer risk was 4.5%. The study revealed that, the likelihood of developing endometrial cancer increased to 12% from %3.2 when the size of the tumor was >150 mm in menopausal patients.