Jessica Ottolina1, Gabriella Ferrandina2, Angiolo Gadducci3, Paolo Scollo4, Domenica Lorusso5, Giorgio Giorda6, Enrico Breda7, Antonella Savarese8, Massimo Candiani1, Fulvio Zullo9, Giorgia Mangili10. 1. Gynecology Department, San Raffaele Scientific Institute, Milan, Italy. 2. Gynecologic Oncology Department, Catholic University of the Sacred Heart, Rome, Italy. 3. Procreative Medicine Department, Pisa University, Pisa, Italy. 4. Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy. 5. Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. 6. Gynecologic Oncology Department, National Cancer Institute, Aviano, Italy. 7. Medical Oncology Department, San Giovanni Calibita-Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy. 8. Gynecologic Oncology Department, National Cancer Institute Regina Elena, Rome, Italy. 9. Department of Obstetrics and Gynecology, University "Magna Graecia" of Catanzaro, Catanzaro, Italy. 10. Gynecology Department, San Raffaele Scientific Institute, Milan, Italy. Electronic address: mangili.giorgia@hsr.it.
Abstract
OBJECTIVE: Granulosa cell 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 GCT 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 40years. All patients with endometrial cancer were older than 40years and postmenopausal. CONCLUSIONS: Endometrial carcinoma/atypical hyperplasia were commonly observed in GCT patients >40years; based on these data, endometrial sampling should be performed in symptomatic women at least 40years of age. In asymptomatic women <40years, endometrial sampling is of low yield.
OBJECTIVE:Granulosa cell 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 GCTpatients 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 40years. All patients with endometrial cancer were older than 40years and postmenopausal. CONCLUSIONS:Endometrial carcinoma/atypical hyperplasia were commonly observed in GCTpatients >40years; based on these data, endometrial sampling should be performed in symptomatic women at least 40years of age. In asymptomatic women <40years, endometrial sampling is of low yield.
Authors: Wiktor Szewczuk; Oksana Szewczuk; Krzysztof Czajkowski; Bartłomiej Grala; Andrzej Semczuk Journal: J Int Med Res Date: 2019-12-23 Impact factor: 1.671