Is pregnancy feasible in women with adult granulosa cell tumors, and how should recurrence during pregnancy be managed? A case report and literature review.
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OBJECTIVE: Granulosa cell tumors are rare ovarian malignancies of sex cord-stromal origin. Improved diagnostics and growing clinical awareness have led to increased recognition in young women of reproductive age, emphasizing the need for individualized treatment strategies that balance oncologic safety with fertility preservation. Despite the increasing relevance of fertility preservation in women with granulosa cell tumors, data on pregnancy and the management of disease recurrence during gestation remain extremely limited, with only few cases reported in the literature.This case may serve as a reference for managing similar cases of granulosa cell tumor or its recurrence during pregnancy. CASE PRESENTATION: A woman was diagnosed with FIGO IC adult granulosa cell tumor (aGCT) and underwent fertility-sparing surgery followed by adjuvant chemotherapy. The desired pregnancy occurred spontaneously after treatment, but a relapse of the disease was diagnosed during the pregnancy. METHODS: We retrospectively analyzed clinical, histopathological, and medical imaging data of a patient diagnosed with an aGCT that was treated at our institution. Relevant information was collected from the patient's medical records to illustrate the diagnostic process, treatment, and outcome. RESULTS: The patient developed two recurrences of an aGCT, one of which occurred during early pregnancy. Surgical management included tumor resection with sigmarectal resection and creation of a descendostomy in the 13th week of gestation. Due to the rarity of such cases, therapeutic planning was based on limited evidence and required an individualized approach. Ultimately, both mother and child remained clinically stable, and the pregnancy proceeded without further complication. CONCLUSION: This case illustrates the complexity of managing recurrent aGCT during pregnancy and highlights the importance of individualized, multidisciplinary treatment strategies. Long-term follow-up remains essential due to the risk of late recurrence.