Stacey Jamieson1, Peter J Fuller. 1. Prince Henry's Institute of Medical Research and Department of Medicine, Monash University, Monash Medical Centre, Clayton, Victoria, Australia.
Abstract
PURPOSE OF REVIEW: Granulosa cell tumours of the ovary are relatively uncommon malignant tumours. Although the majority of patients present with early-stage disease that is curable, approximately 80% of patients with advanced tumours die from recurrent disease. The purpose of this review is to provide the clinician with an update on recent research relevant to granulosa cell tumours. RECENT FINDINGS: The measurement of serum inhibin levels is useful in the diagnosis of granulosa cell tumours in postmenopausal women and for monitoring the disease following oophorectomy at any age. Surgery remains the most effective primary treatment, whereas hormonal therapy for patients with advanced stages or recurrent disease has resulted in varying outcomes. The presence of the gsp oncogene and high GATA-4 protein expression in juvenile granulosa cell tumours may provide new prognostic markers. In-vitro testing of a recently discovered tyrosine kinase inhibitor indicates that further developments in this area may provide a novel therapeutic target for the treatment of granulosa cell tumours. SUMMARY: Further investigation to determine the molecular changes that contribute to tumorigenesis in granulosa cells is required. Understanding the molecular pathogenesis of this disease will potentially provide novel targeted therapeutic options which will improve the survival rate of these patients.
PURPOSE OF REVIEW: Granulosa cell tumours of the ovary are relatively uncommon malignant tumours. Although the majority of patients present with early-stage disease that is curable, approximately 80% of patients with advanced tumours die from recurrent disease. The purpose of this review is to provide the clinician with an update on recent research relevant to granulosa cell tumours. RECENT FINDINGS: The measurement of serum inhibin levels is useful in the diagnosis of granulosa cell tumours in postmenopausal women and for monitoring the disease following oophorectomy at any age. Surgery remains the most effective primary treatment, whereas hormonal therapy for patients with advanced stages or recurrent disease has resulted in varying outcomes. The presence of the gsp oncogene and high GATA-4 protein expression in juvenile granulosa cell tumours may provide new prognostic markers. In-vitro testing of a recently discovered tyrosine kinase inhibitor indicates that further developments in this area may provide a novel therapeutic target for the treatment of granulosa cell tumours. SUMMARY: Further investigation to determine the molecular changes that contribute to tumorigenesis in granulosa cells is required. Understanding the molecular pathogenesis of this disease will potentially provide novel targeted therapeutic options which will improve the survival rate of these patients.
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