Two cases of inoperable recurrent granulosa cell tumor responding to combination therapy with an aromatase inhibitor and a GnRH agonist

Abstract

Synopsis: Ovarian granulosa cell tumors (GCTs) account for about 5% of malignant ovarian tumors. Surgery is the mainstay of treatment, but recurrent cases are not uncommon. Surgery, chemotherapy, and radiotherapy have limitations, and optimal treatment for recurrent cases has not been established. Here we present two cases of inoperable recurrent GCT that responded to combination therapy with an aromatase inhibitor and a GnRH agonist. Case 1 was a 56-year-old woman who had undergone two surgeries for recurrent GCT, which resulted in intestinal injury due to severe intraperitoneal adhesions. The tumor recurred, and she received hormonal therapy with an aromatase inhibitor alone, followed by combination with TC therapy and bevacizumab, both of which were unsuccessful. She received combination therapy with an aromatase inhibitor and a GnRH agonist, which has brought into complete response. Case 2 was an 84-year-old woman who had undergone two surgeries for recurrent GCT, with chemotherapy between them. Both a single aromatase inhibitor and following weekly TC therapy for subsequent recurrence were not effective. So, a combination therapy of an aromatase inhibitor and a GnRH agonist was performed again, which has brought into partial response. Both patients are continuing hormonal therapy with two agents.