GnRH agonist therapy in a patient with recurrent ovarian granulosa cell tumors.
A 65-yr-old woman presented 17 yr status post-hysterectomy with bilateral ovarian salpingo-oophorectomy, attributable to ovarian cancer. She was admitted to our hospital, with multiple cystic liver masses and multiple large seeded masses in her abdomen and pelvic cavity. Histological examination of the pelvic masses demonstrated granulosa cell tumors. After two courses of systemic combination chemotherapy, with paclitaxel and carboplatin, the masses in the abdomen and pelvic cavity increased, and debulking surgery also failed because of peritoneal dissemination with severe adhesion. Finally, she underwent palliative radiotherapy for only the pelvic masses obstructing the urinary and GI tracts, and monthly hormonal therapy with a gonadotrophin-releasing hormone agonist; leuprorelin 3.75 mg IM. Subsequently, multiple masses beyond the range of the radiation as well as those within the radiotherapy field partially decreased. This partial response had been maintained for more than 8 months as of the last follow-up visit. Owing to its long and indolent course and the low metabolic rate of the tumors, advanced or recurrent granulosa cell tumor (GCT) requires treatment options beyond chemotherapy, surgery, and radiotherapy. Hormonal agents may provide another treatment option for advanced or recurrent GCT in those who are not candidates for surgery, chemotherapy, or radiotherapy.
Kim
Hyun Jung
HJ
Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea.
Lee
Sang-Cheol
SC
Bae
Sang Byung
SB
Kwon
Kye Won
KW
Kim
Chan Kyu
CK
Lee
Nam Su
NS
Lee
Kyu Taek
KT
Won
Jong Ho
JH
Hong
Dae Sik
DS
Park
Hee Sook
HS
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000378:metabolism; D006106:Granulosa Cell Tumor / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D012008:Recurrence
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide