Granulosa cell tumor (GCT) is a type of ovarian
sex cord-stromal tumor with low-grade
malignancy, which can recur long after primary resection. All reports on GCTs in the liver describe cases of
metastases, while there are no previous reports of primary GCTs originating from the liver. We report a case of GCT, with recurrence of liver
metastasis long after
ovariectomy, which was subsequently resected by a right trisectionectomy.
CASE PRESENTATION: A 76-year-old woman presented with a history of surgical resection of an ovarian
tumor performed 30 years previously; no details of the
tumor were available. When she was 68 years old, an abdominal ultrasound revealed a small liver mass, which was diagnosed as a hepatic
hemangioma with slow growth. Outpatient follow-up was discontinued for 5 years, and the patient was not examined again until the age of 76 years. At this point, the
tumor had substantially increased in size, and surgical resection was required owing to suspicion of
malignancy. The patient was then referred to our hospital. Contrast-enhanced computed tomography (CT) showed a large
tumor, approximately 18 cm in size, occupying the right lobe and medial section of the liver. After percutaneous transhepatic portal vein embolization, a right trisectionectomy was performed. The histopathological findings of the resected specimen showed that the
tumor cells had "
coffee bean-like" nuclear grooves, which are characteristic of a GCT. Acidophilic non-structural Call-Exner bodies were also observed.
Inhibin-α, CD99, and CD56 markers of
sex cord-stromal tumors were detected on immunohistological examination; all pathology suggested a GCT. We considered the
tumor to be a liver
metastasis of a previous ovarian GCT that was resected 30 years prior by
ovariectomy. There was no recurrence for > 15 months after the
hepatectomy.
CONCLUSIONS: We report a case of a GCT in the liver, which was identified to be a liver
metastasis. Right trisectionectomy was subsequently performed for
tumor resection. Clinicians should be aware that ovarian GCTs may recur in the liver, and that GCT recurrence may occur long after
ovariectomy of the primary ovarian GCT.