Abstract

Granulosa cell tumors are the most prevalent type of sex cord-stromal tumor, constituting approximately 2-5% of ovarian neoplasms. Unlike epithelial ovarian tumors, granulosa cell tumors tend to occur in a younger age group and are frequently detected at an early stage, often presenting with features of hyperestrogenism. The stage of the disease significantly impacts the survival of patients with granulosa cell tumors. Patients with granulosa cell tumors may present with non-specific symptoms such as abdominal pain and distention. Surgical management of these tumors is determined by both the stage of the tumor and the age of the patient. The management of premenarchal women or reproductive-aged patients with early-stage granulosa cell tumors typically involves unilateral salpingo-oophorectomy and appropriate surgical staging. For women who have completed childbearing or are postmenopausal, the recommended surgical approach includes total abdominal hysterectomy and bilateral salpingo-oophorectomy, along with standard surgical staging procedures. The stage of the tumor emerges as the most critical prognostic factor. Notably, 10-year survival rates range from 84-95% for stage I tumors but decrease to 50-65% for stage II disease and further decline to 17-33% for stages III and IV. Patients with low-risk stage I tumors are often placed under observation. However, those with high-risk stage I disease, characterized by factors such as large tumor size (≥10-15 cm), stage IC, poorly differentiated tumors, high mitotic index, or tumor rupture, may be considered for adjuvant chemotherapy due to the increased risk of relapse.