Early Recurrent Granulosa Cell Neoplasm: a Case Report

A 61 year-old woman who has a history of a granulosa cell neoplasm (GCT), removed 1 year prior, presents to the office with increasing abdominal girth and severe limitations in bowel habits. She had been chronically constipated with difficulty walking and transferring secondary to pelvic and abdominal pain. Her primary neoplasm was excised at 15cm in conjunction with a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Upon imaging in August 2019, a new mass was seen measuring at 15cm with septations and loculations; suspicious for a possible recurrent tumor. Surgical excision was planned and executed without morcellation. Extensive carcinomatosis of the small and large bowel were seen, necessitating 2 bowel resections that were successful but leaving the patient with a temporary ileostomy. To date, she has been inconsistent with follow-up and discussion of the necessity of chemotherapy is pending. This patient is unusual in that her GCT was malignant and recurrent, but also the speed at which it returned, only 1.5 years later; both factors being unexpected for this type of tumor.