Adult Granulosa Cell Tumour Presenting as a Huge Ovarian Mass in a Postmenopausal Woman: A Case Report and Review of Management

Abstract

Background: Granulosa cell tumours (GCTs) are rare sex cord-stromal tumours of the ovary, accounting for less than 5% of all ovarian malignancies. Adult-type GCTs typically present in perimenopausal or postmenopausal women and can manifest with non-specific symptoms or hormonal effects such as postmenopausal bleeding. Case Presentation: We report the case of a 65-year-old postmenopausal woman who presented with abdominal swelling and pain. Magnetic Resonance Imaging (MRI) and ultrasonography revealed a large abdomino-pelvic mass. Surgical exploration confirmed a huge ovarian tumour and she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for an early-stage disease [FIGO stage IA]. Histopathological examination diagnosed an adult granulosa cell tumour. Her postoperative recovery was uneventful, and she is currently on surveillance with serum Inhibin B and Anti-Mullerian Hormone (AMH) levels for early detection of recurrence. Conclusion: This case highlights the importance of considering granulosa cell tumour in the differential diagnosis of adnexal masses in postmenopausal women. Early recognition, appropriate surgical management and prolonged follow-up are essential due to the tumour’s potential for late recurrence as seen in the management of this patient who presented with FIGO stage IA disease.