Another peak fre quency corresponds to the prepubertal age. The signs and symptoms are many, abdominal soreness, stomach distension linked to mass effect and hormonal events this kind of as irregular menstruation, intermenstrual bleeding, postmenopausal bleeding or amenorrhea. Nevertheless, for all those circumstances by which the patient is asymptomatic, the clinical examination is very important. Endocrine manifestations are noted in 66% in the pa tients. These manifestations are relevant to estrogen se cretion of the tumor. This explains why the granulosa cell tumors are fre quently linked with endometrial hyperplasia or to endometrial adenocarcinoma. Consequently, endometrial and cervical biopsies are essen tial to define the therapeutic approach. The juvenile form could be characterized through the pres ence of pseudopuberty, and galactorrhea may perhaps comprehensive the clinical pres entation.
The mechanism isn’t clearly established. Radiologicaly speaking, the granulosa cell tumor presents as a solid component with multicystic visual appeal, which has a median diameter of twelve cm. The imaging appearances on the two forms of granulosa cells tumors are very similar. The same clinical selleck and radiological data were noted while in the patients from our examine. The diagnosis is confirmed by histological analyses. The adult form includes 5 subtypes, amongst which the most frequent subtype microfollicular is characterized by Get in touch with Exner bodies and cores coffee bean. Within the juvenile form, the architecture is often lobu lated, Phone Exner bodies are rare, plus the indications of luteini zation are frequent.
The survival costs at 5 many years and 10 many years were reported by Malmstrom et al, 94% and 88%, respectively, for stage I, and decreasing to 44% for stage II and III. Wu et al. also reported their results about sur vival for one hundred individuals with granulosa cell tumors, sur vival costs at 5 many years and ten many years were 98% and 96%, respectively, for stage I and were 70% and 60%, respect ively, for stage Vanoxerine II. The recurrence price can be relevant to your stage. The results of Ahyans study of 80 individuals with granulosa cell tumors, unveiled recurrence prices of five. 4%, 21% and 40% for stage I, stage II and stage III, respectively. The prognostic value of stage was also mentioned in our examine. The primary immunohistochemical markers expressed by these cells are vimentin, CD 99 and alpha inhibin. The serum tumor markers are estradiol, inhibin, and anti M?llerian hormone. Cancer antigen 125 is just not correlated for the tumor progression. Kalfa et al. recognized a mutation FOXL2 while in the majority of granulosa cell tumors, particularly in adult kind. This FOXL2 could be the next target for use in therapy. Yoo et al. also recognized mutations of genes Fas, FLIP and Bcl two connected to alterations of apoptosis.