Background Adult granulosa cell tumors (AGCTs) are the most common sex cord-stromal tumors. disease (61%,??= 19). Two among 3 sufferers with stage IV disease acquired liver organ metastasis. Mitotic index was lower in 45% of situations (= 14). Medical procedures was optimum in virtually all situations (90%, = 28). The median follow-up period was 14 years (1C184 a few months). Ten sufferers relapsed (32%) having a median RFS of 8.4 years (6.8C9.9 years). Mean overall survival was 13 years (11C15 years). Stage I disease and low-to-intermediate mitotic index were associated with a better prognosis in univariate analysis (resp., = 0.05 and = 0.02) but were not independent prognostic factors. Conclusion GCTs have a long natural history with common late relapses. Hence, long active follow-up is recommended. In Tunisian individuals, hepatic metastases were more frequent than occidental series. The prognosis remains good and initial staging at analysis is an Nobiletin price important prognostic element. 1. Intro Granulosa cell tumors (GCTs) represent only 5% of all ovarian cancers. However, they are the most common subtype of ovarian sex-cord tumors (70%) [1]. They 1st were reported by Rokitanski in 1855 [2]. Although there is no consensus within the pathogenesis of these tumors, most investigators believe they originate from early ovarian mesenchyma as they are composed of granulosa cells, theca cells, and fibroblasts in different degrees [3]. Hyperoestrogenism reported in individuals with GCT is related to tumor production of oestrogens, anti-Mllerian hormone, and inhibin B [4]. Relating to histological findings, two different subtypes of GCT were recognized: Nobiletin price adult (AGCT) and juvenile (JGCT). AGCTs are more frequent [5]. Surgery is the mainstay of treatment. Chemotherapy and/or radiotherapy are considered in individuals with advanced stage or with unresectable recurrent disease [3]. In this study, we aimed to describe epidemiologic characteristics of AGCT in Tunisian human population and then Rabbit Polyclonal to RHOD determine relapse and overall survival prognostic factors. 2. Methods We carried out a retrospective single-center cohort study of all individuals with AGCT diagnosed and treated in the Medical Oncology Division at Salah Aza?z Institute for malignancy from Nobiletin price 1995 to 2010. Quantitative variables were indicated as mean and median ideals. Qualitative variables are indicated as complete and relative frequencies. Statistical analyses were performed using SPSS 20.0 software. Kaplan-Meier’s statistical method was used to assess the recurrence-free survival and overall survival (95% confidence interval). 3. Results A total of 31 ladies with a imply age of 53 years (35C73 years) were included in the study. 61% of instances presented with abdominal mass and/or abdominal pain in (= 19). Postmenopausal bleeding was reported in 32% of instances (= 10). Ultrasound imaging was performed in all instances and showed primarily cystic unilateral mass (80%??= 25). Median tumor size was 20?cm (4C33?cm). Abnormally elevated levels of serum tumor marker CA-125 were reported in 42% of individuals (= 13). Inhibin B was not studied in any of our individuals. Histological features recognized were micro/macrofollicles with cores coffee bean (74%), Call-Exner body (55%), and necrosis (22%). Mitotic index measured in only 22 individuals was primarily Nobiletin price low (64%). The staging breakdown was the following: stage I represents 61% (stage IC: 58% of stage I), stage II 10%, stage III 19%, and stage IV 10%. Metastases places had been mainly liver organ (67%) and pleura (33%). The primary treatment was surgery in all cases. 28 patients (90%) underwent hysterectomy with bilateral salpingo-oophorectomy. Nonoptimal surgery was reported in 3 cases (10%). Intraoperative tumor rupture occurred in 5 patients (16%). Adjuvant treatment was chemotherapy followed by hormonal therapy in one woman (3%) and chemotherapy alone in 18 women (58%). No patient received adjuvant radiotherapy. Adjuvant chemotherapy was a platinum-based regimen: cyclophosphamide-cisplatin in 13.