Granulosa Tumor

Dear Doctor,

i am female and 65 years old , and my menses stop when i 50 years old,
when i 64 years i have blood from Vagina again, then i go to hospital
and got result as below
PATHOLOGICAL DIAGNOSIS
1.Endocervix,fractional curettage:
- Few strips of benign endocervical tissue.
2.Endometrium, fractional curettage:
- Simple hyperplasis without atypia.

and after that i got operate ,the doctor cut everthing out (except cervix)
and got result from lab as below,
Pathological Diagnosis
Uterus with both adnexa,sub TAH with BSO:-
Endometrium-simple hyperplasia without atypia
Myometrium-Adenomyosis
                  - Leiomyoma
Fallopian tube,Rt and Lt-Not remarkable
Ovary,Rt-Granulosa tumor ,tumor size 7 cm in diameter,mitosis 4-5/10 HPE,limited invasion within ovarian capsule
Ovary,Lt-Corpus albican

i would like to know this is cancer or not and what stage ,and how should i do to next step

Thank you very much,

[kcd86]

There is one thing I learned about cancer is that treatment varies from patient to patient and that has to be discussed between you and your Dr. In my wifes case the Dr in Sloan Kettering in NYC said since the mass was removed intact and all nodes and pelvic washings were clear she would not reccomend Chemo. Granulosa cell cancer is a slow growing from of ovarian cancer,90% of all cancer drugs are for fast or agressive cancer cells. Granulosa cell cancer is so rare there are not alot patients for drug trials done on this type of cancer. This type of cancer can sometimes never comes back or it can show its ugly head 5,10 and sometimes 15 yrs after initial diagnoses. Try and find out if your surgeon removed this mass/ovary intact because that plays a significant role in determining if you need chem or not along with clean nodes and pelvic washings.
Good Luck
Kevin

[marie3B]

Have your doctor go over this with you and explain everything in detail to your understanding.  The granulosa tumor with limited invasion sounds suspicious to me, but I am no doctor.  I think your doc should have explained the findings as soon as the results came in.  Good luck,  Marie

[kcd86]

I am sorry you have to go threw this it is very stressfull to have this constantly hanging over your head. My wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010 .
There are other types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. Granulosa cell tumors often produce estrogen, and symptoms related to hyperestrogenism are common, as in your case developing vaginal bleeding. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca. They are Inhibin A&B and MIS.
Please keep in mind if and only if you have a diagnoses of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing cancerous tumors as opposed to epitheal ovarian cancer.
My wife's Dr's in Sloan Kettering in NYC said she also has nothing to worry about because they removed the ovary fully intact. Removing the ovary fully intact is an indication for possibly no further tumors will develop.(cross our fingers)
Ask your surgeon if your tumor was removed intact. They also said no further testing is needed. I have her Inhibin A&B done every 6 months. I am not sure what the Inhibin would be called in Thailand. Inhibin is the blood test for estrogen levels. Post menopausel women will have no inhibin in their blood.
You did mention the mitotic level of the cancer cells being 4/5(1-10), this is an index of how potentially virulent or agressive the cancer cells may be. Dr use that # as a guide to see if they want to do further treatment
As Marie3B said sit down and discuss all your concerns and questions with your oncologist.
Regards,
Kevin

[thip134]

Thank you very much for support

take care ,and good luck for you too,

Thip134

[thip134]

Thank you very much for your clarify ,
i post here because  i very confuse with many doctor,
first doctoc who make operate for me ,he said i should be recieve chemotherapy and send me to next hospital ,and second doctor (second hospital) she just read lab result and said
no nothing to do just follow up (one year per time).
and next time i go to third hospital and talk with third doctor he said this is cancer but not aggressive  and i can have a live for more 10 years and make ct scan  for me (make CT Scan after operate 7 month,
and then back to third hospital again and see fourth doctor(in third hospital ,i can select the doctor) and got result CT Scan she said no nothing  in CT Scan
and she have 2 choices to me
first choies =>operate again for see inside and after that have to give chemotherapy to me,
second choies=> make chemotherapy,

i concern about chemotherapy , i don't want to receive chemotherapy, so i post here for many openion , thank you thank you very much, kcd86

[marie3B]

I can understand why you would be confused after having all those doctors.  I also understand not wanting to do chemo.  I have done it off and on for 3 and a half years.  It is no fun, but it has kept me stable for months at a time.  I sure hope you get whatever treatment is best.  I know nothing about your type of cancer, but Kevin knows alot.  Marie

[kcd86]

There is one thing I learned about cancer is that treatment varies from patient to patient and that has to be discussed between you and your Dr. In my wifes case the Dr in Sloan Kettering in NYC said since the mass was removed intact and all nodes and pelvic washings were clear she would not reccomend Chemo. Granulosa cell cancer is a slow growing from of ovarian cancer,90% of all cancer drugs are for fast or agressive cancer cells. Granulosa cell cancer is so rare there are not alot patients for drug trials done on this type of cancer. This type of cancer can sometimes never comes back or it can show its ugly head 5,10 and sometimes 15 yrs after initial diagnoses. Try and find out if your surgeon removed this mass/ovary intact because that plays a significant role in determining if you need chem or not along with clean nodes and pelvic washings.
Good Luck
Kevin

[thip134]

Dear Marie ,and Kevin,

Thank you very much for your advice ,thank you again.

Good luck

Thip