What is Granulosa Cell Tumor?

Granulosa cell tumors are tumors of the ovary (ovary). These are usually slow-growing tumors with a low level of malignancy. Although there is a juvenile and an adult form of the disease, the average age at onset is around 52 years.

What is a granulosa cell tumor?

According to DigoPaul, a granulosa cell tumor is a very rare tumor of the ovary. It belongs to the so-called gonad stromal tumors. Within the group of ovarian tumors, it accounts for only one to two percent. The granulosa cells within the ovary are affected by the growth.

These are located in the multi-layered granule cell layer and are responsible for the formation of the ovule. The egg cell then adheres to the egg mound. The name ” granulosa cell ” comes from Latin and means “granule cell”. Originally, the granulosa cells develop as part of the follicle maturation from the so-called follicular epithelial cells, which originate from the primary follicle.

Follicle maturation takes place under the influence of the follicle-stimulating hormone FSH, which belongs to the gonatropins. One of the functions of the granulosa cells is to secrete the fluid that fills the follicular cavity. After the follicle has ruptured, the granulosa cells build up a layer that forms a shell around the egg cell.

Furthermore, some granulosa cells store lipids and thus form the so-called corpus luteum, which mainly produces the corpus luteum hormone progesterone. In addition, the granulosa cells also produce estrogens. In rare cases, the granulosa cells degenerate and a granulosa cell tumor develops.

There are two forms of this disease. Every twentieth case of granulosa cell tumor begins in adolescence or even in childhood. This is referred to as a juvenile granulosa cell tumor. The adult form of this tumor, which occurs much more frequently, begins on average at the age of 52 years.

Both forms are characterized by increased estrogen production and slow growth. The prognosis is usually good. However, it also depends on the stage at which the disease is discovered and treated.

Causes

Little can be said about the cause of a granulosa cell tumor. The usual risk factors probably lead to degeneration of the granulosa cells, particularly in the adult form.

Spontaneous mutations certainly play a role. How the juvenile form of the granulosa cell tumor develops needs further investigation. Little is known about this disease even today.

Symptoms, Ailments & Signs

The granulosa cell tumor causes two symptom complexes, which are related on the one hand to the increased production of estrogen and on the other hand to the progressive mass of the tumour. The increased release of estrogen can trigger a so-called pseudopubertas praecox in young girls before the actual puberty.

All the symptoms of female puberty appear too early with the premature maturation of the skeleton. The epiphyseal plates close too early, which can lead to short stature. The uterus is constantly stimulated to grow, and bleeding between periods may occur.

Bleeding often occurs after menopause. In some cases, prolonged stimulation of the uterus can also lead to uterine cancer. The other symptom complex relates to the spatial extent of the tumor. The tumor can press on the intestines and cause non-specific symptoms in the abdominal area.

Many patients suffer from bloating, constipation and abdominal enlargement. In the case of large tumors, there is a risk of stem rotation, which can lead to acute abdominal discomfort. The granulosa cell tumor tends to form metastases, which become noticeable through swelling of the lymph nodes in the pelvic area and near the aorta.

Diagnosis

If unusual intermenstrual bleeding occurs and the abdominal circumference increases, imaging procedures such as sonography should be used to search for possible tumors in the abdominal area. Today, the disease is often only recognized at a stage when the tumor has already reached a considerable size.

Only after the operation can a biopsy be used to determine what type of tumor it is. In many cases, the tumor is also found by manual palpation.

Complications

Granulosa cell tumors lead to various symptoms and complications that only affect women. In most cases, puberty occurs prematurely. As a result, the female organs cannot fully develop and short stature often occurs. The uterus can also be affected by heavy and frequent bleeding.

However, the symptoms also occur in adulthood, with women in the menopause being particularly affected. This can also lead to cervical cancer, which can continue to spread to other regions without treatment. The tumor can also press on the intestines, which can lead to various symptoms. In most cases, life expectancy is limited and reduced by granulosa cell tumors.

The tumor is treated surgically without complications. However, it cannot be predicted whether the tumor may have spread to other parts of the body. This can lead to further complications. In most cases, radiation is performed after removal. The earlier the granulosa cell tumor is detected and treated, the higher the patient’s chances of survival.

When should you go to the doctor?

In the worst case, a granulosa cell tumor can lead to the death of the affected person, which is why treatment is absolutely necessary. Short stature may indicate a granulosa cell tumor. If this is recognizable in a person, he or she is dependent on regular examinations later in life in order to avoid further complications and complaints.

Persistent constipation or a strong feeling of fullness can also point to the granulosa cell tumor and should be investigated if these symptoms occur over a longer period of time.

There is generally severe discomfort in the abdomen and also severely swollen lymph nodes. In women, this tumor can also lead to a tumor in the cervix, so that a doctor must also be consulted if there are complaints in this region. First and foremost, if a granulosa cell tumor is suspected, a general practitioner can be contacted.

The doctor then refers the person concerned to the respective specialist, who can make an exact diagnosis. With early diagnosis, the chances of a complete cure increase enormously.

Treatment & Therapy

Once the tumor is discovered, the treatment of choice is its complete removal. In the early stages of the disease, a unilateral adnectomy (removal of the fallopian tube and ovary) and a uterine cavity can be done. In later stages, complete adnectomy makes sense.

In addition, the uterus can also be removed because there is a risk of developing uterine cancer. If metastases have already formed in the lymph nodes, the affected lymph nodes should also be removed. In some cases, even years after the tumor was supposedly completely removed, recurrences form again.

Since the recurrences only grow slowly and with little infiltration, surgery is still a successful treatment method here. In advanced stages of a granulosa cell tumor, supportive chemotherapy or radiotherapy is carried out after the operation. Radiotherapy is used when there are residual tumors that could not be removed during surgery.

Adjuvant (supportive) chemotherapy is given when recurrences occur. Overall, the ten-year survival rate is about 70 to 95 percent. However, it also depends on the stage at which the disease is first treated.

Outlook & Forecast

The prospect of a cure for granulosa cell tumors is subject to various conditions. In principle, the disease occurs exclusively in females and can spread in such a way that it can no longer be treated or treated. This leads to the premature death of the patient. The average death rate is less than twenty percent. With a timely diagnosis and initiation of treatment, there is a good chance of recovery.

Nevertheless, due to the possible therapies, subsequent complaints are to be expected. In some patients, the uterus is surgically removed because no other therapy is possible. The procedure is associated with the usual risks and at the same time it is accompanied by the infertility of the woman. This can trigger emotional as well as mental problems and lead to secondary diseases.

At the same time, the hormonal balance must be changed and supported. When it comes to cancer therapy, numerous side effects are to be expected. Chemotherapy represents a significant intervention in the patient’s lifestyle and triggers various complications. However, with this form of treatment, the probability of survival increases.

In an early stage of the disease, complete freedom from symptoms and recovery can take place through a curettage. If this is successful, the patient can be released from treatment within a short time.

Prevention

Since the causes of granulosa cell tumors are not sufficiently known, no specific preventive measures against this disease can be given. Certainly a healthy lifestyle with a balanced diet, plenty of exercise and little stress to strengthen the immune system generally reduces the risk of developing this tumor.

Aftercare

In the case of a granulosa cell tumor, the patient usually has no options for follow-up care. The patient is primarily dependent on the early detection and treatment of the tumor in order to prevent further complications. There is no self-healing in this disease.

Even after successful treatment of the granulosa cell tumor, regular examinations of the body should be carried out in order to identify and treat new tumors in good time. The life expectancy of those affected may also be reduced by the granulosa cell tumor. This type of cancer is treated with surgery or chemotherapy.

The patient should always rest and protect the body after such an operation. Here, all strenuous and stressful activities or activities should be avoided in order not to unnecessarily burden the body. Even in the case of chemotherapy, unnecessary stress should be avoided.

Those affected with a granulosa cell tumor also need the support of friends and family. This can prevent psychological upsets that could have a negative impact on the further course of the disease. Since the granulosa cell tumor can also come back after treatment, the body should be checked regularly for this tumor.

You can do that yourself

Granulosa cell tumor is a form of ovarian cancer and can only affect female patients. It is a serious and life-threatening disease that must be treated under medical supervision. Therapies usually take place surgically with subsequent chemotherapy or radiation and are carried out by medically trained personnel. The patient therefore has no possibility of treating her illness herself.

Nevertheless, the patient can make a significant contribution to the success of the treatment. First and foremost by following the instructions of her doctors and carrying out the therapies consistently and without interruption as planned. Regular check-ups and discussions about the further course of therapy should be taken care of.

Alongside medical therapy, there are a number of factors that the patient can use to promote her own recovery. A positive attitude towards life can help to better accept and cope with the side effects of the treatment. Since the body is severely weakened by the therapies and possible operations, it should be strengthened and supported from other sources as far as possible.

A healthy and balanced diet that relieves the body helps here. The consumption of alcohol and too much caffeine should be completely avoided, and smoking should definitely be stopped. All of these so-called pleasure toxins consume forces that are otherwise no longer available to the body for healing and regeneration.

Granulosa Cell Tumor