Failure of gonadotropin releasing hormone therapy in patients with metastatic ovarian sex cord stromal tumors.

Ovarian sex cord stromal tumors are usually indolent neoplasms that are generally confined to one or both ovaries at the time of diagnosis. The overall prognosis for these women is good though advanced or recurrent tumors occasionally occur. In such instances, if the tumor is localized, surgical or radiation therapy often provides good results; however, diffuse intra-abdominal disease is uncommon and difficult to treat effectively. Recently, synthetic gonadotropin releasing hormone (GnRH) analogue therapy has been advocated as an effective therapy with low toxicity. We report on 2 women whose advanced recurrent ovarian cord stromal tumors failed to respond to repetitive surgical, chemotherapeutic, and GnRH therapies. In these 2 cases, GnRH therapy was not successful in controlling diffuse spread of two separate gonadal stromal tumors. Systemic toxicity was minimal.