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My wife had just diagnosed with JGCT, she had her surgery before one month ( removed her left ovary which enlarged to 9 cm and about 500 ml of Ascities (Ascities, Lymph Nodes, Omentum = all Negative for Malignancy) Mitioic Rate was 3-4 / 10 HPF, Her Right Ovary , Tubes and Uterus all appeared normal. The doctor had staged 1A, and suggested no further Treatment. CA 125 before Surgery was 192 and post surgery after 1 month was 15. The doctor told the tumor was not ruptured.
My Question here is
1. My wife wife had acute pain in her abdomen one month before surgery, is it means Tumor Ruptured? Bcoz if tumor got Ruptured Staging will be Differed and affect the actual Prognosis.
2. Is there any other option to find out whether there are any residues in her pelvic region or her tumor got ruptured?
these are good questions and you really need to talk to your wife's surgeon to fully understand what was found at surgery.
Also your wife should ask for a copy of the operative report and the pathology report.
if indeed she had a ruptured tumor, the stage is a Stage 1c
it maybe her pain was just from the mass without rupture
in terms of follow up, as she had an elevated CA 125, follow up CA 125 testing can help monitor for recurrence
I would suggest a baseline Ct scan as well.
here is an article on JGCT
Int J Clin Oncol. 2009 Feb;14(1):78-81. Epub 2009 Feb 20.
Juvenile granulosa cell tumor of the ovary presenting with pleural effusion and ascites.
Kaur H, Bagga R, Saha SC, Gainder S, Srinivasan R, Adhya AK, Dhaliwal LK.
Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Juvenile granulosa cell tumor (GCT) is a rare tumor, and the majority (90%) are reported in the prepubertal or under-30-year age group, in contrast to the adult type, which is more common in the fifth decade. On histopathological examination, juvenile GCTs are distinct from the adult type of GCT, and have a lower risk for late recurrences than the latter. Being solid tumors, they may be associated with ascites and pleural effusion (Meigs' syndrome), which resolve after surgical removal of the tumor. Tumor markers for GCT are still investigational (inhibin) and of not much use in making a preoperative diagnosis, unlike in the case of germ cell tumors. In most of the reports about the initial surgical management of GCT, retroperitoneal lymph node sampling was not performed, and it was not done in the patient we report here. However, lymph node sampling is advocated for complete staging of these tumors, as a significant number of recurrences are reported in the retroperitoneum, as well as in incompletely staged patients. In the present patient, because of the association of Meigs' syndrome, a preoperative diagnosis of benign tumors such as fibroma/thecoma was also considered. We report this rare tumor with an aim of reviewing the diagnosis and management from the reported literature.
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