Elevated preoperative serum
inhibin concentrations have been reported in patients with
granulosa cell tumor of the ovary. The aim of this study was to determine if elevations in serum
inhibin predated clinical recurrence in patients with a diagnosis of
granulosa cell tumor. Twenty-seven consecutive patients with
granulosa cell tumor were followed prospectively to assess the relationship between serum
inhibin concentrations and disease status. The serum
inhibin concentrations in normal postmenopausal women were < 77-130 U/liter. In patients with
granulosa cell tumor at initial surgery, mean
inhibin concentrations preoperatively were 2831 U/liter in 4 postmenopausal subjects (range 2130-3323 U/liter) and 3680 U/liter in each of 2 premenopausal women. In 5 postmenopausal subjects with a histological diagnosis of
granulosa cell tumor who underwent secondary surgery because of a recurrent palpable mass, mean
inhibin concentrations were 4216 U/liter (range 2672-7360). In 3 patients with known or suspected residual disease despite a secondary debulking operation the serum
inhibin concentrations were 475, 1000, and 2541 U/liter. In 13 subjects who were clinically disease free with a previous diagnosis of
granulosa cell tumor, serum
inhibin concentrations remained within the normal range for reproductive status. We conclude: (1) Preoperative serum
inhibin concentrations are typically elevated sevenfold above the normal premenopausal follicular phase levels in women with
granulosa cell tumor; (2) after surgery, serum
inhibin levels may become elevated up to 2 years before further surgery is undertaken; and (3) serum
inhibin concentrations appear to be a valuable
tumor marker for the diagnosis of primary or recurrent
granulosa cell tumor.