title: Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy for recurrent adult granulosa cell tumor: A case report.
abstract: BACKGROUND
  Adult granulosa cell tumor of the ovary (AGCT) is a rare functional sex-cord-stromal ovarian neoplasm characterized by low malignant potential and late relapse. Evidence-based management options for women with recurrent AGCT are limited.
  
  
  METHODS
  We present the case of a 60-year-old woman with the fifth recurrence of AGCT initially diagnosed 19 years ago. After initial surgery in 1996, the patient underwent four additional surgical interventions for recurrent disease in 2005 (abdominal wall), 2009 (abdominal wall), 2010 (paravesical), and 2011 (paravesical). In 2011, she underwent pelvic irradiation with 50.5 Gray. In 2015, another recurrence was diagnosed based on an increase of serum inhibin and a tumor seen on CT scan in the right upper abdomen. The patient underwent cytoreductive surgery (CRS) with complete cytoreduction followed by hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin 50 mg/m(2) and doxorubicin 15 mg/m(2). No intra- or post-operative complications occurred. Final histology revealed recurrent AGCT with 6 cm in the largest diameter. Subsequently, antihormonal treatment with anastrozole 1.5 mg per day was prescribed. With a follow-up of six months, the patient is well and alive.
  
  
  CONCLUSIONS
  CRS and HIPEC are a reasonable treatment option for selected women with recurrent AGCT limited to the abdomen.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Askin
authors.initials: A
authors.lastname: Dogan
authors.affiliation: Institute of Pathology, Medical School Hannover, Hannover, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Solass
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
keywords: Adult granulosa cell tumor; Cytoreduction; HIPEC; Intraperitoneal chemotherapy; Ovarian neoplasma