abstract
OBJECTIVE:
granulosa
cells tumors (GCTs) are the most common estrogen-secreting ovarian
tumors; perhaps due to the persistent hyperestrogenism, a wide spectrum
of associated endometrial pathologies ranging from endometrial
hyperplasia to carcinoma has been documented in patients with GCTs. The
aim of this study is to
evaluate the incidence of endometrial
pathologies in a large series of GCTs patients treated in MITO centers.
METHODS:
a
retrospective multi-institutional review of patients with granulosa
cell tumors of the ovary treated or referred to MITO centers was
conducted. Descriptive statistics were used to characterize the patient
population and to assess the association of GCT and endometrial
abnormalities at the time of diagnosis; multivariate regression analysis
was also performed to identify independent predictors of endometrial
abnormalities.
RESULTS:
a
total of 150 patients with primary adult GCT was identified. During the
preoperative assessment, endometrial pathology was found in 35.9% of
symptomatic patients and in 90.9% of asymptomatic women with endometrial
thickening at transvaginal ultrasound. At the time of surgery,
hyperplasia was documented in 29.2% of patients, whereas endometrial
cancer occurred in 7.5% of patients. Almost all of the patients (97.6%)
with endometrial hyperplasia were older than 40 years. All patients with
endometrial cancer were older than 40 years and postmenopausal.
CONCLUSIONS:
endometrial
carcinoma/atypical hyperplasia were commonly observed in GCT
patients>40 years; based on these data, endometrial sampling should
be performed in symptomatic women at least 40 years of age. In
asymptomatic women<40 years, endometrial sampling is of low yield.
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