Cases reported "Granulosa Cell Tumor"

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1/4. Activin B in patients with granulosa cell tumors: serum levels in comparison to inhibin.

    BACKGROUND: activins and inhibins are polypeptide hormones/growth factors of primarily gonadal origin. In the ovary, activins and inhibins are primarily synthesized by granulosa cells. serum inhibin measurements have been used for the follow-up of patients with granulosa-cell tumors (GCT) after surgery. methods: We have employed a recently developed assay to study whether activin B (A) measurements can be used as a marker of progression of GCTs. Additionally, these measurements have been compared with simultaneously run inhibin measurements using a commercial assay. serum samples of three patients suffering from GCTs (all stage Ia) were collected at primary surgery and at controls thereafter. RESULTS: In patient AM, serum inhibin levels have remained elevated while A levels are low; there has been no evidence of a residual tumor. In patient AR, there has been no clinical evidence of a residual tumor, and both serum A and inhibin levels have remained low. In patient PP, a residual tumor was found 6 years after primary surgery; at the time A levels were elevated, while inhibin levels remained low. CONCLUSION: We introduce A as a promising new marker for postoperative follow-up of patients suffering from GCTs.
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2/4. Inhibin as a marker for granulosa-cell tumors.

    Inhibin is a peptide hormone normally produced by ovarian granulosa cells. It reaches a peak of 772 /- 38 U per liter in the follicular phase of the menstrual cycle and is undetectable in the serum of menopausal women. To determine whether measurements of serum inhibin levels would provide a biochemical marker of the presence or progression of ovarian granulosa-cell tumors and their metastases, we measured the serum immunoreactive inhibin concentrations in six women with such tumors. Three women had been treated by hysterectomy and bilateral salpingo-oophorectomy. In the two women with residual or recurrent disease, the serum inhibin levels were abnormally elevated 5 and 20 months before the clinical manifestations of recurrence became evident. The maximal concentrations approached 3000 U per liter. The serum inhibin level remained undetectable in one patient who was disease-free for 11 years. serum inhibin concentrations were also elevated in three women with amenorrhea and infertility that resulted from small granulosa-cell tumors. After the removal of the tumors, the serum inhibin levels in these women became normal, and fertility returned. There was a significant negative correlation between the serum concentrations of inhibin and follicle-stimulating hormone, in a manner consistent with the autonomous production of inhibin by granulosa-cell tumors. We conclude that granulosa-cell tumors produce inhibin. Since serum inhibin levels reflect the size of the tumor, measurements of inhibin can be used as a marker for primary as well as recurrent disease.
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3/4. Successful liver treatment of a juvenile granulosa cell tumor in a 4-year-old child by regional deep hyperthermia, systemic chemotherapy, and irradiation.

    Juvenile granulosa cell tumors (JGCT) of the ovary are rare in children and adolescents. About 90% are diagnosed in early-stage FIGO I with favorable prognosis. More advanced stages (FIGO II-IV) have a poor clinical outcome and chemotherapy alone cannot avoid tumor progression. Regional deep hyperthermia (RHT) induced by microwave technique has been established as an additional modality for treatment of different tumors. However, in cases with liver involvement there are technical problems which have not yet been solved. We report on a 4-year-old child who suffered from diffuse liver metastases 10 months after JGCT of the left ovary. After chemotherapy including ifosfamide, etoposide, and carboplatin in combination with RHT and consolidation radiotherapy, the patient has been in complete remission for 1 year of follow-up. This Case Report indicates the feasibility of combining surgery, chemotherapy, hyperthermia, and radiation therapy (which can also be an effective treatment modality for advanced granulosa cell tumor) for the treatment of liver metastases of JGCT, but does not allow comparisons of these treatments.
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4/4. Precocious pseudopuberty due to a granulosa cell tumour in a seven-month-old female.

    We describe a juvenile granulosa cell tumour resulting in pseudopuberty in an infant female. The progression of the clinical signs of puberty were non-consonant and the diagnosis was complicated by marginally elevated serum alpha-fetoprotein levels. The histological appearance of the resected tumour and binding of MIC2 antibody to tumour cells confirmed the diagnosis.
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